Today's Top 20 Stories

  1. 22 million people could lose cost-free mammograms under preventive care court ruling: Report

    Rylee Wilson -
    Over 20 million women between the ages of 50 and 64 could lose access to cost-free mammograms if a court ruling striking down requirements for payers to cover preventive care at no cost is upheld, according to a report from the Robert Wood Johnson foundation. 

  2. Friday Health Plans pauses Colorado enrollments

    Andrew Cass -
    Friday Health Plans will not accept new health plan enrollments in Colorado for the remainder of 2023 after an agreement was reached with the Colorado Division of Insurance. 

  3. Virginia Premier Medicaid members shifting to Optima Health

    Andrew Cass -
    Virginia Premier will move its 300,000 Medicaid members to Optima Health on July 1.

Target the full spectrum of cardiometabolic conditions for better member outcomes, plan savings

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  1. HealthPartners names senior vice president for health solutions

    Rylee Wilson -
    HealthPartners has named Megan Schmidt senior vice president of health solutions. 

  2. $14M Centene office space up for sale

    Rylee Wilson -
    An office building Centene invested millions in but rarely used is up for sale, the St. Louis Business Journal reported May 9. 

  3. Minnesota fines HealthPartners for mental health parity violations

    Rylee Wilson -
    The Minnesota Department of Commerce alleges that HealthPartners violated mental health parity laws by analyzing claims for mental health and substance abuse treatment more stringently than other types of care. 

  4. AHIP: Best practices for Medicaid redeterminations

    Rylee Wilson -
    Best practices for state Medicaid programs during the unwinding of continuous coverage requirements include strong communications, a bolstered workforce and transparent data, according to AHIP. 

3 ways to address No Surprises Act compliance challenges

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  1. Oscar Health posts $39.6M loss in Q1

    Rylee Wilson -
    Oscar Health improved its year-over-year losses in the first three months of 2023. 

  2. Baton Rouge General strikes deal with Cigna, but Aetna impasse remains

    Andrew Cass -
    Baton Rouge (La.) General has reached an agreement on a new contract with Cigna but remains out of network with Aetna, The Advocate reported May 9. 

  3. Oscar Health to exit California market in 2024

    Rylee Wilson -
    Oscar Health will exit the California individual ACA insurance market for plan year 2024 as part of a push to make its insurance business profitable. 

  4. 8 prior authorization updates

    Andrew Cass -
    From Google Cloud launching an artificial intelligence-powered claims acceleration suite to CMS issuing a final rule to streaming the Medicare Advantage prior authorization process, here are eight prior authorization updates Becker's reported since April 6: 

Target the full spectrum of cardiometabolic conditions for better member outcomes, plan savings

Sponsored
Only 2.7% of US adults live a healthy lifestyle — & that costs health plans $500B a year. This approach supports better outcomes + employer savings.

  1. Former UnitedHealth VP tapped for Athenahealth C-suite role

    Andrew Cass -
    EHR vendor Athenahealth named George Hamilton chief corporate strategy and development officer. 

  2. Gold Kidney Health Plan names former UnitedHealthcare plan exec as COO

    Rylee Wilson -
    Gold Kidney Health Plan, a payer offering Medicare Advantage special needs plans, has named Gregg Kunemund as chief operating officer. 

  3. In Chattanooga, former payer campuses could become schools, housing

    Rylee Wilson -
    Government officials want to turn an 11-acre BlueCross BlueShield site for sale in Chattanooga, Tenn., into a public school campus. 

  4. 73,000 people lose Medicaid coverage in 1st month of Arkansas' redetermination speedrun

    Rylee Wilson -
    Arkansas terminated Medicaid coverage for almost 73,000 people in April, including 44,667 people who had their eligibility extended during the COVID-19 public health emergency. 

  5. Bright Health posts $169M loss in Q1

    Rylee Wilson -
    Bright Health Group improved on its losses year over year and upped revenue in the first quarter of 2023. 

  6. Medicare Advantage as a percentage of all Medicare enrollment, year by year

    Andrew Cass -
    Medicare Advantage enrollment now represents half of total Medicare enrollment, according to a May 1 analysis from the Kaiser Family Foundation. 

  7. Centene shareholder proposals zero in on executive pay

    Andrew Cass -
    Centene shareholders will vote on a pair of proposals that take aim at executive pay, the St. Louis Post-Dispatch reported May 9. 

  8. Centene beats COVID-19 reimbursement lawsuit

    Andrew Cass -
    A Connecticut medical practice's lawsuit alleging Centene failed to reimburse it for COVID-19 testing services has been thrown out after the practice missed a deadline to refile the case. 

  9. UnitedHealthcare, Northeast Georgia Health split amid contract impasse

    Andrew Cass -
    Gainesville-based Northeast Georgia Health System went out of network with UnitedHealthcare's employer-sponsored and individual plans after the two sides were unable to reach a new contract, UnitedHealthcare said in a May 1 news release. 

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