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United kicks off 2021 by cutting a critical NYC safety-net health system from its network as COVID-19 cases reach record highs

Here’s a trend we saw in 2020 and will likely continue to see in 2021: UnitedHealthcare forcing providers to choose between accepting dramatic pay cuts or being cut out of United’s network.… Read More

UnitedHealthcare hikes cost for municipal employer by almost 10 percent amid a year of record-breaking pay cuts and job losses

Like most employers, the City of Philadelphia, MS, will be seeing the cost of health insurance for its employers increase next year. What’s unique about this story, however, is how clearly it… Read More

Consumers seeking comprehensive coverage should watch out for this predatory United health plan 

When Sam Bloechl was buying a comprehensive health plan, one he believed would cover him for a life-threatening illness; he did not know he was sick. A subsequent cancer diagnosis led doctors… 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

Unanimous Supreme Court decision is a blow to PBMs and the insurers that own them

In 2015, Arkansas passed a law prohibiting pharmacy benefits managers (PBMs) from reimbursing pharmacies less than what it cost to acquire a drug. The law was challenged by the PBM lobbying group… Read More

Six health insurance executives to keep an eye on in 2021

The COVID-19 pandemic has forced many industries to pivot. The entertainment industry has taken to Zoom and other virtual formats to continue providing “live” shows. The restaurant industry has shifted to takeout,… Read More

Survey indicates COVID-19 pandemic adding to insurance cost burdens

A new survey from The Commonwealth Fund (reported on in Healthcare Dive) brings more bad news from the ongoing COVID-19 pandemic. The survey confirms what we already knew—that insurance premiums and deductibles… Read More

CVS and Aetna tighten their grip on market choice with this new plan

As we eagerly stumble into 2021, let’s take a quick look back to 2019 for a moment: CVS closed on a mega-merger deal with Aetna designed to give Aetna members access to… Read More

The five most important things to know about hospital financial losses amid the COVID-19 pandemic

Earlier this month, we covered a Becker’s Hospital Review article about the more than 30 hospitals forced to file for bankruptcy this year and described the factors that could put hospitals in… Read More

This is how much revenue United projects for 2021. Spoiler: it’s a lot

It’s been well documented that insurers have profited from a drop in care utilization during the pandemic, while providers experienced a sharp drop in revenue with many elective procedures being postponed or… Read More

Public opposition to new lab coding policy pushes UnitedHealthcare to hit pause

Back in November, we covered a Health Leaders story about a new lab coding requirement UnitedHealthcare planned to implement in early 2021, smack in the middle of cold and flu season and… Read More

Here’s what members and employers need to get more from the health insurance industry

Health insurance has always been a highly valued employee benefit, and now in the midst of the COVID-19 pandemic, it is even more true. Access to healthcare, including access to health insurance… Read More

UnitedHealthcare squeezes Gaston County’s only hospital during worst pandemic months

Residents of Gaston County with UnitedHealthcare insurance are expected to face higher costs at Gaston County’s only hospital, CaroMont Regional Medical Center. This is due to UnitedHealthcare terminating their CaroMont Health contract.… Read More

Non-profit to for-profit? NJ’s largest insurer seeks corporate restructure

New Jersey’s largest health insurance company, Horizon, says that a corporate restructuring will allow it to better invest in technology, build partnerships, and cut costs of care. Patient advocates say it’s an… Read More

Over 30 hospitals have been forced to file for bankruptcy this year

2020: the year COVID-19 flipped the world upside down. COVID-19 continues to have a disproportionately detrimental impact on the healthcare industry, as pre-COVID-19 many hospitals were already struggling. Even before the global… Read More

New research shows just how hard it is for consumers to understand their insurance options

It’s open enrollment season again, which means that employees across the country are assessing the insurance options offered by their employers and trying to understand which plan will offer the most value… Read More

Employers give C+ to health plans overall, and even lower grades to United

In summer 2020, nonprofit watchdog The Leapfrog Group surveyed more than 170 employers on their satisfaction with health plans’ responsiveness, transparency, payment reform, and value. When asked to grade their health plan… Read More

The five most important things to know about Cigna’s newly branded health services unit, Evernorth

Recently, we covered an article by HealthcareDive that discussed Optum’s advantage in vertical integration in the health insurance industry. While there is no question that Optum continues to lead the pack, we… 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

Six health insurance CEOs made more than $15 million each in 2019

It’s not uncommon for health insurance executives’ massive annual compensation packages to make the news, and 2019 was no exception. Last year, six health insurance CEOs received an excess of $15 million… 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

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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.