Skip to Content

UnitedHealthcare ordered to reprocess 67,000 behavioral health claims

Back in October, we shared a Bloomberg article about insurers violating the spirit of the The Mental Health Parity and Addiction Equity Act. At the center of this story was a lawsuit… Read More

Cigna accused of fraudulently overbilling Medicare Advantage plans

In August, the complaint in a federal whistleblower lawsuit against Cigna was unsealed. In it, Cigna is accused of collecting billions of dollars in overpayments from its HealthSpring Medicare Advantage plans. How… Read More

What if a COVID-19 diagnosis could be used against health plan members?

If the ACA is struck down by the Supreme Court, the protection it provided for people with pre-existing conditions will no longer exist. Insurers will go back to being able to charge… Read More

As virtual doctor’s visits rise in popularity, major health insurers change the rules

Up until COVID-19 hit, utilization of virtual care was extremely low. Most people had never tried telehealth; some weren’t even aware that they could connect with doctors and nurses from their phones… Read More

United piles on more coding to already exhausted and overwhelmed providers

In September, UnitedHealthcare released a plan that will require all in-network freestanding and outpatient lab claims to include a unique code for testing services. This code is in addition to existing standard… Read More

Health insurance doesn’t assure you of anything in the U.S.

Why does anyone buy health insurance? To ensure they have access to the healthcare services they and their families need. Unfortunately, having coverage today doesn’t always mean care is covered, nor does… Read More

Health insurers stockpile savings while hospitals battle costly pandemic

During the COVID-19 pandemic, hospitals and health systems have fully embraced their role in responding to the public health crisis, moving mountains to offer community testing services and providing care for patients… Read More

Oops! Blue Cross Blue Shield of Texas pays big for billing mistakes

This March, after state investigators determined that Blue Cross Blue Shield of Texas had made major billing mistakes related to out-of-network emergency claims, the insurer agreed to pay a $10 million fine… Read More

Americans fight insurers for mental health coverage as suicide is on the rise

The Mental Health Parity and Addiction Equity Act, passed more than a decade ago, requires insurers to cover mental health care in a way that is comparable to other medical treatments. Yet,… Read More

Show me more proof!

Sign up to receive our regular roundup of the latest evidence of payors’ bad behavior across the healthcare ecosystem.

Subscribe