Today's Top 20 Stories
  1. MyChart message fees live on unstable ground

    When Cleveland Clinic said it would begin billing for certain Epic MyChart messages this November, it set off a fiery debate across the healthcare industry around hospital finances, patient access and physician burnout.
  2. Centene to pay Oregon $17M in latest Medicaid overbilling settlement

    Centene will pay Oregon $17 million to settle allegations the payer overcharged the state's Medicaid program for pharmaceutical services, the Oregon Justice Department said Dec. 6. 
  3. 6 things to know about the 1st year of the No Surprises Act

    The No Surprises Act, which protects consumers from out-of-network charges for emergency care and other services, took effect Jan. 1 of this year. 

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  1. 'Back in a place that unfortunately we know really well': COVID care entering new phase for uninsured

    The $25 billion in federal funds given to healthcare providers over the course of the pandemic is drying up, which could leave the nearly 30 million uninsured Americans footing the bill for their future COVID-19 care, The New York Times reported Dec. 6. 
  2. High deductibles can discourage women from seeking additional cancer screenings, study finds

    Deductibles can deter women from seeking additional screening after abnormal findings on a mammogram, a study presented Nov. 29 at the Radiological Society of North America found. 
  3. The cities with the most competitive commercial insurance markets

    Many local commercial and exchange markets are largely controlled by one payer, according to the American Medical Association. 
  4. Medicare Advantage in the headlines: 9 recent updates

    Medicare Advantage plans have faced scrutiny for possible upcoding and pressure to update provider directories. Here are nine Medicare Advantage updates Becker's has reported since. Nov. 18. 

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  1. Cigna in the headlines: 9 recent developments

    From adding Humira biosimilars to its pharmacy formulary to Evernorth becoming a minority owner in VillageMD, here are nine stories about Cigna that Becker's has reported since Nov. 9: 
  2. Oklahoma hospital warning of possible UnitedHealthcare dispute ahead of enrollment deadline

    UnitedHealthcare and Tulsa, Okla.-based Hillcrest HealthCare System will be out of network if the two sides do not reach a contract agreement by May 1, 2023, ABC affiliate KTUL reported Dec. 5. 
  3. Humana, BCBS Texas cut ties with San Antonio home health firm after owner charged with premiums theft

    Humana and Blue Cross Blue Shield of Texas have canceled their contracts with San Antonio-based Superior Home Health Services after the owner was indicted in connection with the theft of employee insurance premiums, ABC-affiliate KSAT reported Dec. 2.
  4. Wellmark BCBS names chief wellness and innovation officer

    Wellmark Blue Cross and Blue Shield has named Keith Shah as executive vice president and chief health and innovation officer. 

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  1. Independence Blue Cross names two seniors vice presidents

    Independence Blue Cross has promoted Sushma Akunuru to senior vice president of business technology services and Kortney Cruz to senior vice president of government markets.
  2. Prior authorization is 'No. 1 physician and administrative concern in America,' senator says

    The sponsor of the Senate's version of a bill to reform the Medicare Advantage prior authorization process called prior authorization the "No. 1 physician and administrative concern in America."
  3. 18 million could lose Medicaid coverage at end of PHE, new estimates show

    Updated estimates from the Urban Institute and Robert Wood Johnson Foundation show that 18 million people could lose Medicaid coverage when the COVID-19 public health emergency ends. 
  4. Not just 'window dressing': What 7 leaders said about payer health equity efforts this year

    Payers are investing in health equity in many ways, including improving data collection, access to virtual care and adding health equity experts to C-suites. 
  5. Cigna adds Humira biosimilars to formulary

    Cigna will add Humira biosimilars to its pharmacy formulary, giving the new, cheaper alternative products hitting the market next year the same position as the drug. 
  6. 9 Medicare Advantage plans audited for upcoding by OIG in the last 6 months

    The HHS' Inspector General's Office released audits of nine Medicare Advantage plans over the last six months, according to the organization's semiannual report to Congress, published Dec. 5. 
  7. Partnership HealthPlan, NorthBay Health strike deal

    Partnership HealthPlan of California and Fairfield, Calif.-based NorthBay Health reached a contract that will keep the nonprofit healthcare organization in network with the health system. 
  8. Alabama Medicaid agrees to remove sobriety mandate for hepatitis C drugs

    Alabama Medicaid reached an agreement with the Justice Department to end a longstanding policy that denied coverage of hepatitis C medication for those who consumed alcohol or drugs within six months of starting treatment or while using the medication.  
  9. Aetna, Community Healthcare System at contract impasse

    Aetna and Munster, Ind.-based Community Healthcare System will go out of network if the two sides cannot reach a contract agreement by Jan. 15, Inside Indiana Business reported Dec. 5. 

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