Healthcare Finance Staff

Deficiencies found in an audit of Cigna-HealthSpring operations has prompted the Centers for Medicare and Medicaid Services to temporarily bar Cigna from enrolling new customers to its Medicare Advantage and stand-alone prescription drug plans, and from marketing efforts, according to CMS.

Unlike insurance sold to individuals and small businesses through online marketplaces, large employers are not required to offer a list of "essential health benefits." 

Health insurer Centene Corp. on Monday said it has lost six hard drives containing the health information of about 950,000 beneficiaries.

Pennsylvania Insurance Commissioner Teresa Miller was the latest state official to propose protections for healthcare consumers against surprise balance bills, when she announced new measures on Tuesday.

Thirty-five percent more people than last year have enrolled for their employer-sponsored healthcare benefits on private online marketplaces, according to a new report from global consulting and technology firm Accenture.

Driven by a $720 million loss on its individual exchange product, UnitedHealth Group on Tuesday reported a $6.8 billion profit in 2015, down $238 million over its 2014 profit.

As the third open enrollment period winds down on the health insurance marketplaces, one thing hasn't changed much since the online exchanges opened: It's still often hard to find out whether a plan covers abortion services.

Health plans reimbursed customers approximately $478 million in 2014, translating to about $129 per family receiving a refund, according to data aggregation firm Mark Farrah Associates.

Six million renew plans while 2.5 million are newly insured through marketplace.

A pre-authorization process for certain medical supplies has worked to bring down costs in sample studies and will help prevent questionable billing practices.