Anthem BCBS of NY seeks dismissal in ‘ghost network’ case
Accused of crafting a “ghost network” of doctors, Anthem BCBS of NY says the case is a matter of federal, and not state, jurisdiction.
The latest news, regulation and trends in health and employee benefits.
Accused of crafting a “ghost network” of doctors, Anthem BCBS of NY says the case is a matter of federal, and not state, jurisdiction.
Medicare Advantage plans increasingly rely on middlemen for marketing, a move that is hiking costs and making it more difficult for government to oversee and regulate the health plans that millions of older Americans rely on. That was among the findings of a report released last week by Sen. Ron Wyden, D-Ore., the ranking member of the Senate Finance Committee.
Startup Ansel Health has carved a niche in the supplemental health insurance space in its effort to provide a better way.
A community-led partnership in Colorado designed to negotiate health care prices lowered health care premiums in 2020 and 2021, we find in our new paper in the Journal of Risk and Insurance. The nonprofit organization is called the Peak Health Alliance. In this most recent study, we evaluated Peak Health Alliance, which initially launched in Summit County,…
2025 APR 03– By a News Reporter-Staff News Editor at Insurance Daily News– Current study results on Skin Diseases and Conditions- Alopecia have been published. Our news journalists obtained a quote from the research from the University of Toronto,“ There has been a lack of objective surveillance to determine the proportion of dermatologists in practice who…
2025 APR 03– By a News Reporter-Staff News Editor at Insurance Daily News– A new study on Managed Care is now available. According to news reporting originating from New York City, New York, by NewsRx correspondents, research stated,“ Despite major expansions in public health insurance under Medicaid and the Children’ s Health Insurance Program over the last 60…
In a filing with state regulators this week, UCare reported by far its worst annual financial results in 15 years of records reviewed by the Minnesota Star Tribune— a loss on operations of $504 million in 2024.. The operating loss helps explain why the Minneapolis- based health insurer sent messages to insurance agents in late March suspending commissions to…
In a battle of corporate behemoths, an arm of UnitedHealth Group claims it will lose access to critical software unless it capitulates to“ exorbitant” price increases demanded by vendor Broadcom Inc.. United Healthcare Services sued Broadcom Wednesday over software that is“ ubiquitous” throughout the Eden Prairie- based health insurer’ s computer systems.
In a filing with state regulators this week, UCare reported by far its worst annual financial results in 15 years of records reviewed by the Minnesota Star Tribune— a loss on operations of $504 million in 2024.. The operating loss helps explain why the Minneapolis- based health insurer sent messages to insurance agents in late March suspending commissions to…
It’ s a holy grail of health care: forcing the industry to reveal prices negotiated between health plans and hospitals— information that had long been treated as a trade secret. And among the flurry of executive orders President Donald Trump signed during his first five weeks back in office was a promise to“ Make America Healthy Again” by giving patients accurate…
A community-led partnership in Colorado designed to negotiate health care prices lowered health care premiums in 2020 and 2021, we find in our new paper in the Journal of Risk and Insurance. In this most recent study, we evaluated Peak Health Alliance, which initially launched in Summit County, Colorado, in 2020 and then expanded to seven other rural Colorado…
MetLife, a leading dental insurance provider focused on advancing quality oral health with innovative solutions, has teamed up with SKYGEN, an industry leader in technology-driven services for dental and vision benefits administration, to transform the way dental providers interact with insurance carriers and streamline the credentialing process.
Scotts Bluff County Commissioners were presented with a proposal to consider a change to their health care off erings for employees during budget discussions Monday, March 31. "I can mention a couple things, because I think I'm the one that instigated this discussion, somewhat," Chairman Mark Harris said. The importance of department heads getting proposed…
–North Carolina Republican state Rep. INDIANAPOLIS– Health insurance companies are under increasing scrutiny for allegedly using artificial intelligence bots and algorithms to swiftly deny patients routine or lifesaving care— without a human actually reviewing their claims. The high-profile killing late last year of UnitedHealthcare CEO Brian…
Changes the Kentucky General Assembly ordered in Medicaid face an uncertain future after Gov. For the second year in a row, Beshear last week sent the House and Senate a letter listing bills they had passed without providing what Beshear said was the necessary funding. The Republican-controlled legislature took no action in response to the Democratic…
The measure committed money from a special tax on health insurance plans to increase payments to doctors and health care facilities that treat low-income patients in Medi-Cal, the state's Medicaid program. It also means that California will lose federal matching dollars intended to boost the Medi-Cal program during that time period.
The study, conducted by Urban Institute researchers with support from the Robert Wood Johnson Foundation, calculated that up to 39% of the 13.3 million adults in that age group who became eligible for Medicaid when their states expanded the program under the Affordable Care Act would lose coverage if Congress required states to impose work rules.
ATLANTA- Republican-backed legislation denying coverage of gender-affirming health care though the State Health Benefit Plan advanced in the Georgia House of Representatives Tuesday. The House Health Committee approved a bill that originated in the state Senate and passed that legislative chamber in February. The House panel added a provision to…
Mari Villar was slammed by a car that jumped the curb, breaking her legs and collapsing a lung. Amy Paulo was in pain from a femur surgery that wasn't healing properly. Insurers frequently limit such sessions to as few as 20 a year, a KFF Health News examination finds, even for people with severe damage such as spinal cord injuries and strokes, who may need months of…
HENRICO, Va.— Sheldon Ekirch spends a lot of time on hold with her health insurance company. Sometimes, as the minutes tick by and her frustration mounts, Ekirch, 30, opens a meditation app on her phone. Patients with Ekirch's condition don't always respond to IVIG, but she said she deserves to try it, even though it could cost more than $100,000.
It's a holy grail of health care: forcing the industry to reveal prices negotiated between health plans and hospitals— information that had long been treated as a trade secret. And among the flurry of executive orders President Donald Trump signed during his first five weeks back in office was a promise to "Make America Healthy Again" by giving patients accurate…
It's a holy grail of health care: forcing the industry to reveal prices negotiated between health plans and hospitals— information that had long been treated as a trade secret. And among the flurry of executive orders President Donald Trump signed during his first five weeks back in office was a promise to "Make America Healthy Again" by giving patients accurate…
Cecil Brockman, D- Guilford, filed four bills Wednesday to extend universal coverage statewide over school meals, pre-kindergarten enrollment, health insurance coverage and baseline minimum personal income. Brockman, the lone High Point resident in the 170- member N.C. General Assembly, has some of the poorest areas in the state in his 60th House District.