-
Investigation reveals UnitedHealth, Cigna, Aetna made millions in fees from out-of-network claims
Major insurers made millions in fees by using MultiPlan, a data analytics firm, to determine how much to pay providers for out-of-network claims, according to an investigation from The New York Times. -
7 prior authorization updates
From Point32Health announcing home health prior authorization cuts to a state's proposed gold carding program legislation failing, here are seven updates on prior authorization that Becker's has reported since March 21. -
Clover Health faces delisting threat for 2nd time
For the second time in just shy of a year, Clover Health is facing a possible Nasdaq delisting. -
CVS Health's 5 highest-paid executives in 2023
CVS CEO Karen Lynch was paid $21.6 million in total compensation in 2023, according to a regulatory filing published April 5. -
Payer outlook clouded by rising Medicare utilization: Fitch
A Medicare utilization surge in the fourth quarter of 2024 is clouding the health insurance industry's outlook in 2024, according to an April 8 report from Fitch Ratings shared with Becker's. -
BCBS Massachusetts boosting reimbursement rates to small primary care practices
Blue Cross Blue Shield of Massachusetts is increasing reimbursement rates to qualifying small, independent primary care practices. -
Why one payer CEO feels good about CMS' Medicare Advantage rates
Clover Health CEO Andrew Toy feels good about CMS' 2025 Medicare Advantage rates. -
CareFirst BCBS offers support in wake of Baltimore bridge collapse
CareFirst BlueCross BlueShield is offering space in its Baltimore headquarters for Small Business Administration employees assisting business owners in the wake of the Francis Scott Key Bridge collapse. -
Healthcare services ranked by Medicare Advantage utilization increases
Medicare Advantage plans saw utilization rates rise 8.1% in the fourth quarter of 2023, primarily driven by outpatient and emergency room services, according to an AHIP survey. -
Point32Health to make prior authorization cuts
The parent company of Harvard Pilgrim Health Care and Tufts Health Plan is updating prior authorization for home health services as it conducts a larger review of its requirements. -
Centene in the headlines: 8 updates
From Vanguard Group acquiring the sale of its scrapped East Coast campus, to completing the sale of its U.K. companies, here are eight updates on Centene that Becker's has reported since Feb. 6: -
Rising medical costs offset revenue gains for Independence Blue Cross
Investment income drove a $377 million net income for Independence Blue Cross in 2023. -
Centene's scrapped East Coast campus sold
Investment advisory firm Vanguard Group is acquiring the Charlotte, N.C.-based office campus that was once planned to be Centene's East Coast headquarters, the Charlotte Business Journal reported April 2. -
Weight loss drugs ranked by Medicare Part D spend
Medicare total spending hit $5.7 billion in 2022 after rebates for GLP-1 drugs such as Ozempic, Wegovy and Mounjaro, up from $57 million in 2018, according to a March 22 KFF analysis. -
BCBS must face antitrust conspiracy claims from Ford Motor, judge rules
A federal judge has ruled that the Blue Cross Blue Shield Association and BCBS Michigan must face a lawsuit from Ford Motor Co. over an alleged antitrust conspiracy among Blues plans to fix healthcare prices, thereby overcharging Ford for health insurance provided to its employees. -
Medicare premiums may rise as plans move to cover Wegovy
Wegovy was approved in March to reduce the risk of heart attack and stroke in adults with heart disease, paving the way for Medicare coverage of weight loss drugs. Now, healthcare policy experts anticipate monthly premiums for millions of Medicare enrollees could increase by 2026, though the amount by which prices may jump remains to be seen. -
Home Depot asks Supreme Court to rule on $2.7B BCBS antitrust settlement
Home Depot has asked the U.S. Supreme Court to consider its challenge to a $2.67 billion settlement with Blue Cross Blue Shield companies following a decade long legal battle over alleged anticompetitive behavior. -
AI Can Prevent Millions of Dollars in Losses Amid CMS Part D Regulatory Overhauls
The CMS Part D Redesign Program is set to introduce transformative reforms in the cost-sharing structure for members, health plans, and other stakeholders. These adjustments will hopefully increase affordability and accessibility for members, however, health plans will face significant financial challenges, which could potentially include increases in operational costs due to higher cost-sharing requirements for Part D medications. -
Medicaid redeterminations 1 year later: 10 numbers to know
It's now been one year since the first states began redetermining Medicaid eligibility following a three-year period of continuous coverage enrollment during the COVID-19 public health emergency. -
UnitedHealth Group in the headlines: 12 updates
From the Senate Finance Committee planning a hearing with CEO Andew Witty to regulators reviewing the company's proposed acquisition of Amedisys, here are 12 updates on UnitedHealth Group that Becker's has reported since March 15:
Page 3 of 50