Tag Archives: insurer

Lawsuit alleges Centene’s narrow networks led to surprise medical bills

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Photo: Paul Sableman via FlickrCentene’s St. Louis-area headquarters.

Policyholders of St. Louis-based Centene allege in a new lawsuit that the health insurer’s narrow network system is overly restrictive and limits access to doctors in 15 states. One policyholder who served as a plaintiff in the suit said she received surprise medical bills for treatment from out-of-network doctors.

In Harvey v. Centene Corp., filed Jan. 11 in U.S. District Court for the Eastern District of Washington State, policyholders Cynthia Harvey of Spokane, Wash., and Steven Milman of Travis County, Texas, said they bought their policies from Centene subsidiary companies. Continue reading →

Joseph Burns (@jburns18), an independent journalist who resides in Brewster, Massachusetts, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.

Close eye on SEC filings uncovers DOJ targeting of another Medicare Advantage insurer

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Bob Herman

We reported last month that the U.S. Department of Justice was investigating the risk-adjustment practices of UnitedHealth Group and WellMed Medical Management. At the time, a question remained about whether the DOJ would look into the risk-adjustment or claims-coding activities of other health insurers.

Turns out that Bob Herman, the health care business reporter for Axios, already had the answer. Continue reading →

Joseph Burns (@jburns18), an independent journalist who resides in Brewster, Massachusetts, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.