Aetna

Aetna, an Ohio Medicaid contractor, accused of denying kids care in Pennsylvania

BY: - October 27, 2021

In a case that could have implications for Ohio, a Pennsylvania whistleblower is accusing Aetna of making it impossible for the parents of some kids on Medicaid to find doctors. The insurer then pocketed money from the state for services not rendered, the suit alleges. Aetna denies the charges. The case is relevant here because […]

Firm that facilitated $22B in contracts won’t say if any went to its clients

BY: - October 26, 2021

When the Ohio Department of Medicaid this year selected six companies to manage $22 billion worth of managed-care business, it was supposed to be a competitive process. But some pretty big questions linger about how competitive it actually was.  Somehow, an Ohio-based company was dinged because it hadn’t worked outside the Buckeye State. But giant, […]

Ohio’s Medicaid director owns the stock of some major contractors, but won’t say how much

BY: - October 6, 2021

Since she became director of the Ohio Department of Medicaid in January 2019, Maureen Corcoran has owned stock in some of the department’s biggest contractors. Given the size of those contracts, they could have increased the value of the stock Corcoran owned. But while she complied with one set of state disclosure requirements, Corcoran won’t […]

Court ruling could spotlight questionable practices by health care companies

BY: - July 6, 2021

When you’re emailing about medical billing, it’s probably best not to write about using “dummy codes” to “bury” administrative fees. But two huge health care companies did just that between 2012 and 2016, and now it’s an issue that is poised to get new attention. Ohio is already suing one of the companies, claiming improper […]

Federal probe of drug middlemen urged

BY: - May 10, 2021

After years of accusations in Ohio and elsewhere, a bipartisan group in the U.S. Senate wants federal regulators to investigate whether drug middlemen and their parent companies are rigging the system to raise prices and pad their pockets. Sens. Chuck Grassley, R-Iowa, and Maria Cantwell, D-Wash., last month filed legislation that would require the federal […]