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Misled consumers fight back against “junk” health plans

“What you see is what you get” wasn’t the case for more than 200,000 consumers who thought they were scoring good deals on decent health insurance plans. Burned by a deceptive marketing… Read More

Legislators push to prevent a sudden loss of telehealth services after COVID-19

One of the few upsides of the COVID-19 pandemic has been the rapid rise of telehealth. In the past, federal legislation has limited Medicare coverage for telehealth, but thanks to policy changes… Read More

Did Cigna take advantage of a surge in COVID-19 hospitalizations to deny claims?

New York resident Dinah Nissen was bitten on her right cheek by a dog in mid-May. After a clinician at a local urgent care urged her to see a plastic surgeon immediately,… Read More

Update on United’s acquisition of Change Healthcare: Shareholders and providers expressing concern

In early January, we shared our point of view on UnitedHealthcare’s planned acquisition of the data company, Change Healthcare. To no one’s surprise (at least not ours), there is some controversy surrounding… Read More

CMS is pushing payors to improve prior authorizations processes

It looks like prior authorizations—or more specifically, the myriad challenges providers face around prior authorizations—are becoming an Un-covered theme. If you’ve been following our feed, you’ll recall that we recently shared our… Read More

Insurers in Massachusetts sued for hawking misleading plans

We recently covered how UnitedHealthcare’s short-term health plan Golden Rule was able to shirk responsibility for covering a man’s cancer treatment. Now, Massachusetts Attorney General Maura Healey is suing three health insurance… Read More

Cigna sued for refusing to cover COVID-19 testing

Life as we knew it completely changed in March, when the country began navigating the new normal of living in a pandemic. The novel coronavirus completely dominated the spring news cycle, and… Read More

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

Colorado’s attorney general takes the unusual step of intervening in a proposed United merger

The 2017 acquisition of DaVita Medical Group by UnitedHealthGroup had impacts across the country, but the strongest opposition to the deal came from the Colorado State Attorney General Phil Weiser, who took… Read More

United sued for overpayment recovery methods with employer health plans

Occasionally, insurers determine that they have overpaid providers for care given to their plan members. Sometimes providers determine they have been underpaid by payors for care given to plan members. With a… 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

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