Aetna Medicaid has expertise serving high-need Medicaid members, including those who are dually eligible for Medicaid and Medicare. Currently, Aetna Medicaid owns and/or administers Medicaid managed health care plans under the names of Aetna Better Health and other affiliate names. Together...
Aetna Medicaid has expertise serving high-need Medicaid members, including those who are dually eligible for Medicaid and Medicare. Currently, Aetna Medicaid owns and/or administers Medicaid managed health care plans under the names of Aetna Better Health and other affiliate names. Together, these pl...
the medical benefits ratio (MBR) soaring to 90% from 86% in prior year and the medical loss ratio (MLR) going up to 89.6% from 86.2%. These were attributed to increased utilization, the decline in Medicare Advantage Star ratings, Medicaid acuity...
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Aetna to Pay $5.7B for Coventry Health ; Aetna Is Boosting Its Medicaid and Medicare BusinessAetna Inc., one of the nation's biggest health insurers, claimeda bigger stake in the burgeoning...Murphy, Tom
In August 2007, the Centers for Medicare & Medicaid Services (CMS) concluded that lumbar artificial disc replacement (LADR) is not reasonable and necessary for the Medicare population over 60 years of age. CMS announced that Section 150.1 of the Medicare National Coverage Determination (NCD) Manual...
OIG recommended the Centers for Medicare & Medicaid Services (CMS) edit system processes to reduce payments to hospice enrollees in this scenario and help educate hospitals. “Specifically, our medical reviewer found that Medicare paid acute-care hospitals for outpatient services that palliated or mana...