RADAR on Medicare Advantage | New Third-Party Marketing Oversight Duties Have Industry Scrambling Before AEP

After observing a high volume of marketing-related complaints that the federal government believes are driven by the actions of third-party marketing organizations (TPMOs), CMS this month is implementing several new requirements aimed at protecting Medicare beneficiaries as they compare coverage options during the 2023 Annual Election Period

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Health Plan Weekly | Behavioral Health Network Issues Lead to $4.6M Fine for Molina

Meeting Medicaid network adequacy requirements for behavioral health providers continues to be a challenge for health insurers, as shown by a recent $4.6 million settlement between Molina Healthcare, Inc., its former behavioral health subsidiary, Pathways of Massachusetts, and the Department of Justice.  In the case, Molina and Pathways

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