Radar on Medicare Advantage

Centene Becomes Target as Two States Rebid Medicaid Pacts

Centene Corp.’s handling of pharmacy benefits in its managed Medicaid contracts has now become the subject of separate investigations in two states. Following the news of Ohio’s attorney general suing Centene ov...
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© 2024 MMIT

Calif. Blues Plan Sees Promise in Diabetes Reversal Platform

Diabetes prevention and diabetes management are both key tenets of Medicare Advantage insurers’ approach to addressing this costly condition that impacts one in three Medicare enrollees. But one tech-savvy startup...
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© 2024 MMIT

OIG: T-MSIS Lacks Full Medicaid Managed Care Payment Data

A new review of the CMS Transformed Medicaid Statistical Information System (T-MSIS) found that most states did not provide complete or accurate data on managed care payments to providers for January 2020, according...
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© 2024 MMIT

News Briefs

✦ Aiding in its efforts to deliver timely care and meet members in their “preferred environments,” Anthem, Inc. on March 24 said it will buy home-based nursing management company myNEXUS, Inc. According to a...
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© 2024 MMIT

Banking On MA’s Bright Future, Alignment Joins IPO Trend

An earlier version of this story incorrectly said Alignment Healthcare, Inc. launched its initial public offering on March 18; it only established the pricing range and had not begun trading that day. Orange, Cal...
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MA Plans Test New Flexibilities Targeted to Diabetic Members

From lowering cost sharing on select services to participating in the new Part D insulin model, Medicare Advantage insurers are incorporating new benefit flexibilities into their overall management of diabetes, whic...
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SCAN Considers Caregiver Hesitancy in Vaccine Efforts

As supply and scheduling issues have created slowdowns in COVID-19 vaccinations across the country, Medicare Advantage insurers are naturally concerned about their vulnerable senior members and are taking part in nu...
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Social Needs During Pandemic Highlight Equity Opportunities

Long before the COVID-19 pandemic broke out, Medicaid managed care organizations were working with limited revenue streams and navigating across various waivers to address social determinants of health (SDOH). But t...
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News Briefs

✦ Federal Medicaid officials this week issued letters to Arkansas and New Hampshire informing them of the Biden administration’s formal revocation of their “community engagement” waivers. The Supreme Court...
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Likelihood of Part D Revamp Increases With COVID Relief Bill

As Congress is likely to look for offsets through future budget reconciliation measures and new reports spotlight the soaring cost of prescription drugs in Medicare Part D, industry experts agree that a legislative ...
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© 2024 MMIT