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Insurer policies limit coverage and disrupt patient care, while producing record profits for corporate shareholders. Stay informed with the Un-covered newsletter.
Payors are masters at maneuvering the legal system to advance their dominance of healthcare—suing any entity that gets in their way, defending themselves in anti-trust and other lawsuits, and paying millions in secret settlements.
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
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.
Yet another lawsuit for this Big Insurer over its subsidiaries’ sketchy Medicaid behavior, this time in laid-back Louisiana
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
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 “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 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
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
Remember back in May, when Blue Cross Blue Shield (BCBS) settled for a cool $2.67 billion in a highly publicized antitrust case? We sure do. Here’s a refresher: The BCBS Association was… Read More
The Centers for Medicare & Medicaid Services (CMS) suspended enrollment in not one, but three Medicare Advantage plans offered by UnitedHealthcare. What happened? Well, the Social Security Act requires that health insurance plans have… Read More
A new court case has us predicting more False Claims Act suits against private payors operating Medicare Advantage plans. Let’s hope so, but first, let’s break it down. First: Medicare Advantage. Private… Read More
When a football game goes into overtime, it’s exciting, competitive, and generally applauded. But when enforcement of health insurer transparency goes into overtime, it’s frustrating, exhausting, and costly. Per a recent Fierce… Read More
Centene might not be one of the Big Five health insurers, but it sure knows how to “follow the leader” when it comes to sneaky business. Oh, and did we forget to… Read More
So, let’s say a woman you know is diagnosed with breast cancer, and with the right healthcare, she beats it. It’s a tough fight, but she beats it. Everybody breathes a sigh… Read More
Do you ever wonder whether some insurers may simply have chosen the wrong line of work? The basic exchange in health insurance entails receiving money from people who want their healthcare needs… Read More
Insurers like to lay the blame for surprise medical bills on providers. Sometimes, they’re even brazen enough to blame their own members, claiming that they have failed to scrutinize their insurance coverage… Read More
Is it just us, or do health insurers seem to be, um, taking advantage of Medicare Advantage (MA)? This year alone, we’ve seen stories about Cigna and Anthem hitting stop signs on their… Read More
The New York Times recently devoted more than 1,000 words to the legal dispute between UnitedHealthcare and the private-equity-backed, physician-owned practice U.S. Anesthesia Partners (USAP). It’s an illuminating read—here are the highlights.… Read More
In the past few weeks, we’ve seen a glimpse of what Humana might look like as it grows in size and becomes a bigger employer. And, to be honest, we’re a little… Read More
When the Mississippi Department of Medicaid contracted with Centene Corp. subsidiary Magnolia Health to manage care for the nearly half a million lower-income adults and children in its Medicaid system (MississippiCAN), state… Read More
You may have read our earlier coverage of UnitedHealthcare subsidiary Optum’s intended purchase of Change Healthcare, the enormous administrative network that processes claims and medication requests for physicians and pharmacies. Recently, the… Read More
There seem to be a lot of antitrust issues with health insurers at the moment. Today’s tale involves a suit against Michigan Blues (the umbrella name for Blue Cross/Blue Shield and Blue… Read More
Well, here we are again. Yet another group is calling in counsel—and calling out insurers—on their shady practices related to pharmacy benefit managers (PBMs). This time, it’s Ohio’s attorney general Dave Yost,… Read More
We feel for the UnitedHealthcare legal team. They must be worn out these days, what with so many lawsuits taking them to task for alleged misdeeds like fraud and illegally refusing to cover… Read More
Insurer policies limit coverage and disrupt patient care, while producing record profits for corporate shareholders. Stay informed with the Un-covered newsletter.