Managed Care
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Medicare Advantage star ratings trigger stock jumps, lawsuit
Medicare Advantage star ratings are in!
Nearly Three-Quarters of Medicare Advantage Enrollees Could be Denied a Medigap Policy Due to a Pre-Existing Condition
This analysis examines the share of Medicare Advantage enrollees who have a pre-existing condition that could result in a Medigap denial if they seek to switch to traditional Medicare outside their on...
Centene joins insurers waiving prior authorizations for top providers
Centene is the latest insurer to adopt a gold card program as states and the Trump administration push for prior authorization reform.
CMS-0062 and drug prior authorization: Are you ready?
CMS-0062 and drug prior authorization: Are you ready? Cohere Health
What Could Medicaid Work Requirements Mean for People with Disabilities Waiting for Medicare Coverage?
This analysis finds that Medicaid covered over 1 in 4 SSDI applicants and beneficiaries waiting to become eligible for Medicare (120,300 people out of a total 415,300 in 2023). In future years, people...
Electronic prior auth goes live Jan. 1. Will ASCs see any of it?
Electronic prior auth goes live Jan. 1. Will ASCs see any of it? Becker's Payer Issues
Medigap Guaranteed Issue Requirements: An Overview of Federal and State Rules
This issue brief analyzes federal and state rules related to guaranteed issue requirements for Medigap policies and how they impact beneficiaries’ access to Medigap, including the implications for Med...
Key Facts About Medigap Enrollment and Premiums for Medicare Beneficiaries
This brief presents facts about Medigap, including the characteristics of Medicare beneficiaries with a Medigap policy, variation in Medigap enrollment by state, and Medigap premiums.
Centene to launch prior authorization gold card program
Centene to launch prior authorization gold card program Modern Healthcare
Electronic prior auth goes live Jan. 1. Will ASCs see any of it?
Electronic prior auth goes live Jan. 1. Will ASCs see any of it? Becker's ASC