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

Medicare is big business. It changes a little or a lot every year, and millions have strong opinions about it.

Once you turn 65, you’re generally entitled to Medicare coverage. But you don’t have to stick with original Medicare (Parts A ...

Medicare Advantage plans are popular, but some have limited provider networks, while and others require high cost sharing for ...

In the past few years, new plans with extended health care benefits have been developed, assisting baby boomers with ...

Healthcare expenses can be overwhelming, especially for those living on a fixed income. Fortunately, Medicare Savings ...

Managed Healthcare Executive provides C-suite executives at health plans and provider organizations with news, analysis, ...

Given the prevalence of managed care, it’s incumbent upon the industry to ensure that there is a robust supplier pool.

Shifting from reducing MA capitation by an across-the-board coding intensity adjustment factor to Medicare Advantage ...

President Donald Trump was handed an opportunity to "save" Medicare Advantage after the Biden administration's final proposal ...

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