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The investigations follow testimony in a lawsuit by a former Aetna medical director who said he relied on information from nurses, without reviewing patient records himself, when deciding which treatments to allow and deny.
But state officials are trying to get assurances from the Internal Revenue Service that the new law does not conflict with federal rules for health savings accounts.
In a low-tech snafu, information about HIV treatment was visible through the cellophane window on envelopes sent to about 12,000 consumers.
What will the mega-merger mean for consumers and the health care industry? Senior correspondent Chad Terhune offers insight.
Ineligible for subsidies, a Tennessee woman quit her job to get an affordable health care premium. Conventional steps such as maxing out your 401(k) contribution each year may also do the job, financial planners say.
Public outrage over surprise medical bills prompted 21 states to pass consumer protection laws. But these laws largely ignore ambulance rides, which can leave patients stuck with hundreds or even thousands of dollars in bills.
What to do if you get hit by an exorbitant ambulance bill and how to avoid them in the first place.
Many states have adopted strong consumer regulations, but they dont protect the millions of Americans with a specific type of job-based coverage.
The Department of Managed Health Care cited one example in which consumers and advocates had to call the insurer 22 times to contest a decision. Still, the complaint still was not resolved until the department became involved.
Medicaid is rarely associated with getting rich. But some insurance companies are reaping spectacular profits off the taxpayer-funded program in California, even when the state finds their patient care is subpar.
UnitedHealth, a health industry goliath, has its hand in doctors offices, surgery centers, technology services and prescription drugs. It is the industry model, and CVS and Aetna, says one expert, are wannabes.
After regulators questioned Anthems forecast for medical costs, the company agreed to reduce rate hikes on its individual and small-business health plans next year, saving customers an estimated $114 million.
People who become disabled because of accident, injury or illness can turn to long-term disability insurance to pay a portion of their income.
Even though the Affordable Care Act has dodged another legislative bullet, it still faces challenges.
The insurer says hospital-based imaging services are too expensive and the independent facilities provide high-quality care.
The companys drug spending prediction, far above other insurers in the individual market, has experts scratching their heads. Anthem cites market volatility.
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The average provider network includes only 11 percent of all the mental health care providers in a given market, according to a study this month in the journal Health Affairs.
Insurers can reduce benefits or change cost sharing, but they are generally supposed to tell enrollees about the change beforehand. And although plans must tell patients when they are denied coverage, sometimes treatment is affected for other reasons.
Making needed fixes to Obamacare before next year may be more difficult and expensive than Senate leaders think, state insurance commissioners suggested at a Senate hearing Wednesday.
In this episode of What the Health? Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Paige Winfield Cunningham of The Washington Post and Margot Sanger-Katz of The New York Times discuss the continuing efforts in Congress to repeal and replace the Affordable Care Act, upcoming open enrollment for individual insurance and Congress long health care to-do list for September.
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