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

The contracts will involve tens of billions of dollars in the coming years, with about 3 million people receiving health care ...

Gold Coast Health Plan (GCHP) connected more Medi-Cal members with vital health care screenings and immunizations in 2023, surpassing regulatory health care quality metrics and ranking it as one of ...

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

House lawmakers on Tuesday passed several pieces of legislation that would curb some of the Medicaid savings measures ...

Significant changes to Florida's Medicaid managed-care system take effect this month, impacting millions of beneficiaries ...

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 ...

If, as a state, we truly want to prioritize the health of our children, we must acknowledge that oral health is the gateway and critical part of overall health. The state Medicaid program’s oral ...

Self-managed teams empower employees with autonomy, fostering trust, innovation, and engagement. They redefine leadership, increase efficiency, and drive results.

Insurance coverage of preventive care is on the line as Braidwood Management v Becerra moves to the Supreme Court this year.

The technology to leverage healthcare data exists. The problem, according to Highlander Health, is outdated structures and ...