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Advocates hold signs protesting health insurance denials during a news conference on Medicare Advantage plans in front of the U.S. Capitol in Washington, D.C., on July 25, 2023.
Aetna Inc. (/ ˈ ɛ t n ə / ET-nə) is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare.
Aetna, Sunflower Health Plan and United Healthcare Community Plan have been contracted MCOs since 2018. The MCO contracts were rebid in 2023 and seven entities responded to the request for proposals.
Because of their similarity, both the CIGNA appeal and the Aetna appeal were argued before the Supreme Court together, determining the reach that Pilot v. Life might have on HMOs, with the 5th Circuit Court possibly having reversed prior ERISA-related US Supreme Court decisions. Making arguments before the Court included lawyers for CIGNA and ...
Hackensack Meridian Health, locked in a contract dispute with Aetna, has sent letters to the insurer's customers warning them that they may lose in-network coverage if the two sides can't reach a ...
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Coventry Health Care, Inc. was a health insurer in the United States. It had 3.7 million medical members, 1.5 million Medicare Part D members, and 900,000 Medicaid members. [ 2 ] In May 2013, the company was acquired by Aetna for $5.7 billion.
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