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No surprises here: Insurers failing to uphold their end of the No Surprises Act

It seems simple: Established in 2022, the No Surprises Act seeks to limit the amount of out-of-pocket expenses that patients might get stuck with when their insurance company is out of network… Read More

Another algorithm to say ‘no’ to your care

Nice try, UnitedHealthcare . . . The nation’s largest health insurer has recently found itself in hot water over an algorithm it uses to deny rehabilitation care for Medicare Advantage beneficiaries. According… Read More

Hospitals attempt to stay afloat amidst nasty contract negotiations

Every few years, contract negotiations between payors and providers pull back the curtain on the innerworkings of the American healthcare system. The findings are gruesome. For reference, a recent article in Becker’s… Read More

News flash: your health insurer thinks it knows more than your doctor

“Not medically necessary.” Says who…a doctor? No…an insurance company. And the insurance company here isn’t just any insurance company: we’re talking about UnitedHealthcare, the largest insurance company in the country. A company… Read More

Despite millions in settlements, Centene’s doing just fine

In case you’re not up to speed on the drama, managed care organization Centene is no stranger to legal settlements. We call it ‘managed care mischief’ — when a private company is… Read More

No surprises here: Another suit alleges insurers have the upper hand in claims disputes

Maybe in 2023, the federal government will employ a fair way to settle billing disputes between hospitals and insurance companies. But with the Texas Medical Association (TMA) filing its third lawsuit this… Read More

A deep dive into the risks of the UnitedHealth and Change Healthcare merger

What if there was an opportunity to make the biggest health insurance conglomerate in the United States even more powerful by equipping them with boatloads of sensitive health data? Imagine no more.… Read More

Sugar and spice, not everything’s nice…

It’s the holiday season, a time for peace and goodwill, right? Well, not quite. Because it’s also the season for contract negotiations, err . . . disputes. And it looks like insurers… Read More

It’s another legal loss for UnitedHealthcare

It’s another loss for UnitedHealthcare (United) in its ongoing legal battle with TeamHealth. The Tennessee-based emergency physician company has filed a total of ten lawsuits against UnitedHealth Group, but its most recent… Read More

Anthem is heading to court (again)

The artist formerly known as ‘Anthem’ can’t escape its legal woes. You may remember back in 2020 when the health insurer paid $594 million toward the Blue Cross Blue Shield Association antitrust… Read More

Need medical care? Better prove it.

We all (unfortunately) know that getting your care covered by insurance is anything but simple. And for families with children with autism spectrum disorder, insurers like Trustmark Health Benefits make the process… Read More

Another prior authorization delays patient care and ends in tragedy

OK, we admit it. We’re (fairly) snarky when it comes to health insurance companies. But there’s no room for snark when it comes to a recent Medscape article, which follows the journey… Read More

TeamHealth and UnitedHealthcare get in the ring . . . again

Does a Nevada lawsuit with UnitedHealthcare (United) sounds familiar? Well, since TeamHealth filed ten lawsuits against UnitedHealth Group last December, alleging underpayment for TeamHealth physicians – it might! In the first case,… Read More

‘No-fault’? Yeah, right. Centene’s foibles are starting to add up

It’s been a while since we’ve done a good ‘ole update in our series, Managed Care Mischief. But not to worry — we’re back and headed to New Mexico, where Centene, known… Read More

For Anthem, a rose by any other name . . .

Drumroll, please. Because later this month, Anthem will become … wait for it: ‘Elevance Health.’ This is the health insurance company’s second rebrand in a decade, and you’re not alone in wondering… Read More

It’s time for another contract dispute round-up

Are insurer contract disputes ‘business as usual’? A recent Becker’s Payer Issues article rounds up eight recent disputes between health plans and hospitals — from Maine to Mississippi, Colorado to Georgia, and… Read More

UnitedHealthcare’s ‘evil empire’ strikes back against a new lawsuit

Break out the popcorn for this one.   According to a recent article in HealthLeaders, UnitedHealthcare has found itself in yet another legal battle. United is no stranger to being sued and at… Read More

Reading between the lines in the latest hospital/health plan split

The separation of a Maine hospital from one of the nation’s biggest health insurers speaks to an overarching pattern: the unending blame game of health insurers.

The good times may be coming to an end for UnitedHealth Group

Yet another lawsuit for this Big Insurer over its subsidiaries’ sketchy Medicaid behavior, this time in laid-back Louisiana

Did a recent ruling in the Lone Star State embolden BCBSNC’s abuse of the No Surprises Act?

What’s that old phrase? “The road to hell is paved with good intentions”? As it turns out, the No Surprises Act is living proof that, no matter how much the federal government… Read More

UnitedHealthcare’s tactics aren’t so bright in the Sunshine State

It’s time to roll out the insurer red carpet – straight to court! According to an article in the Orlando Sentinel, UnitedHealthcare (United) recently shelled out more than $4.7 million to UF… Read More

Centene and the settlement saga

“Centene” and “settlement” are two words that have come up so many times this year, we can’t even count. And it’s not stopping yet. Another million-dollar settlement is on the table for… Read More

The (first) jury is in, and UnitedHealthcare takes the hit

The jury has deliberated; the gavel has landed, and an insurance company is forced to face the repercussions of its actions. According to a recent article in Modern Healthcare, Tennessee-based emergency physician company… Read More

Centene and the Managed Care Mischief

Our friends Centene Corporation are back with the next installment of our favorite series: Managed Care Mischief. According to an article in Healthcare Dive, Centene’s settled another set of allegations that it… Read More

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