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Sarah J. Lorance Discusses CMS Audits that Revealed Concerning Repeat Issues
CMS audits have found that some health insurance plans are struggling with the same issues year after year, which is concerning, said Sarah J. Lorance, vice president of Medicare compliance at Anthem.
CMS audits have found that some health insurance plans are struggling with the same issues year after year, which is concerning, said Sarah J. Lorance, vice president of Medicare compliance at Anthem (formerly called WellPoint).
As a result of the audit results, CMS has added stronger language to ensure plans do internal assessments and, if they find they are having the same or similar issues, to work quickly to fix those areas of concern, she explained.
“It tells me that because these issues are repeating year after year, they really are areas that all plans are struggling with,” Ms Lorance said.
Managed Care Reflections: A Q&A With Charles N. (Chip) Kahn III, MPH
July 30th 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The August issue features a conversation with Charles N. (Chip) Kahn III, MPH, the president and CEO of the Federation of American Hospitals and a longtime member of the AJMC editorial board.
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It Take a Village in Cancer Care: A Q&A With David Nguyen, MD
July 23rd 2025David Nguyen, MD, medical oncologist with Tufts Medicine and Lowell General Hospital, discusses the evolving landscape of advanced cancer treatments like chimeric antigen receptor T-cell therapy and bispecific antibodies
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Effects of Adjunctive Cariprazine Formulary Restrictions in Major Depressive Disorder
July 23rd 2025Patients who experienced a formulary-related rejection of cariprazine for adjunctive treatment of major depressive disorder had significantly higher hospitalization rates than those with approved claims.
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