Becker's Payer Issues | Payer News

Five insurers lead the industry in public-facing Medicare plan shopping resources, according to an October report from Corporate Insight shared with Becker’s. The report evaluated 18 insurers’ public websites across homepage and menu navigation, Medicare product overview pages, Medicare Advantage…

Traylor Rains has been named CEO of Aetna Better Health of Oklahoma. He will lead Medicaid strategy and operations serving SoonerSelect enrollees. Mr. Rains previously served as Oklahoma Medicaid director and has held senior leadership roles with the Oklahoma Department…

Twenty-three percent of Medicaid beneficiaries with hepatitis C received treatment within six months, according to an HHS Office of Inspector General report published Nov. 2.  OIG identified roughly 230,000 Medicaid beneficiaries with the disease in 2023. According to the report,…

Tulsa, Okla.-based Hillcrest HealthCare System is no longer in network with Aetna as of Nov. 1. Hillcrest and Aetna have been unable to reach a new agreement, according to the health system. Hillcrest said the update affects roughly 15,000 people…

The ACA marketplace open enrollment period began Nov. 1, with consumers facing higher average premiums, fewer plan options in some states and new regulatory scrutiny. Seven notes:

UnitedHealthcare will stop requiring prior authorization for more than 2,000 pediatric care codes for members under 18 starting Dec. 1. The payer published the full list of CPT codes Nov. 2. The codes span common services, diagnostic imaging, sleep studies,…

Insurers are rolling out commercial offerings for 2027, and many are navigating a landscape of greater affordability pressures on employers and, ultimately, their employees.  Professional services firm Aon projected that average employer healthcare costs could surpass $19,000 per employee in…

Inland Empire Health Plan is in preparation mode as the Medicaid managed care plan faces the loss of up to 350,000 members as a result of the impending impact of HR 1. “We’ve got to do everything we can to…