Prior authorizations are the way MA managed care plans pre-approve some procedures before they’ll pay for them.

Molina Healthcare Inc (MOH) reports robust full-year premium revenue growth despite facing higher medical costs in Q4 2024.

LaTeena Smith pleaded guilty in December to submitting fraudulent bills for psychotherapy services for Medicaid managed care patients.

The Ensign Group, Inc. (Nasdaq: ENSG), the parent company of the Ensign group of companies, which provide post-acute healthcare services ...

STATEWIDE— NEW YORK STATE DEPARTMENT OF HEALTH'S eMedNY COMPUTER system improperly paid $16.2 million in Medicaid claims during a six-month period that started in October 2023, reports an audit that ...

The more complex and labor-intensive esoteric tests are reimbursed at a higher rate and often outsourced by hospitals to independent labs. Labcorp is funneling resources to broaden its menu of complex ...

Molina Healthcare CEO Joseph Zubretsky downplayed GOP proposals to slash spending on Medicaid, which accounts for about 80% ...

Here are 5 illnesses you might not know that you can treat from your own home with Mobile Inpatient Care at Home ...

Pharmacy benefit managers, insurance companies, and pharmacists debated the causes and potential impacts of the new proposal ...

A key federal funding commitment has been renewed that's at the heart of making possible North Carolina's ground-breaking ...

PEPFAR, the main U.S.-funded global AIDS program was given a waiver from the foreign aid freeze, but there is still ...

The company's founder and former CEO, cardiologist Dr Chip Grant, will now assume the roles of executive chair and chief ...