Managed Care

Why Is Medicare Advantage Overpayment and Fraud So Hard to Stop?
Management & Administration Why Is Medicare Advantage Overpayment and Fraud So Hard to Stop?

The Medicare Advantage program, designed to provide seniors with an alternative to traditional Medicare, has faced persistent issues of overpayments and fraud for over a decade. Despite the numerous efforts by the Centers for Medicare & Medicaid Services (CMS) to address and rectify these

Can Molina Healthcare Thrive Amid Medicaid Market Challenges?
Management & Administration Can Molina Healthcare Thrive Amid Medicaid Market Challenges?

Molina Healthcare, Inc. (NYSE: MOH) has become a significant player in the Medicaid services sector, focusing primarily on low-income individuals and families. Despite many achievements in recent years, the company faces a series of challenges that could impact its future. This article dives into

How Will Proposition 35 Impact California's Medicaid Funding?
Management & Administration How Will Proposition 35 Impact California's Medicaid Funding?

California's voters will soon decide on a significant healthcare measure, Proposition 35. This proposition seeks to permanently authorize a tax on managed healthcare insurance plans, aimed at securing ongoing funding for the state's Medi-Cal program, which serves low-income residents.

How Will Medicare Changes in 2025 Affect Your Health Coverage?
Management & Administration How Will Medicare Changes in 2025 Affect Your Health Coverage?

The upcoming changes to Medicare in 2025 are set to bring significant modifications that will impact beneficiaries nationwide. With the open enrollment period from October 15 to December 7, it is crucial for those on Medicare to stay informed and review their options carefully to make the best

Why Did Huntsville Hospital and UnitedHealthcare Split After Talks?
Management & Administration Why Did Huntsville Hospital and UnitedHealthcare Split After Talks?

The recent termination of the relationship between Huntsville Hospital (HH) and UnitedHealthcare has resonated throughout the healthcare landscape, leaving many patients and stakeholders searching for answers. After extended and unproductive negotiations, this split has significant implications for

Will Texas's Medicaid Contract Disputes Disrupt Health Services?
Management & Administration Will Texas's Medicaid Contract Disputes Disrupt Health Services?

Texas is facing a significant legal challenge that has the potential to impact the healthcare services of nearly 1.8 million residents. Recently, the Texas Health and Human Services Commission (HHSC) sought to implement new Medicaid contracts for its STAR and CHIP managed care programs, which

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