Today's Top 20 Stories
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Humana sues HHS over new Medicare Advantage clawback rule
Humana is challenging a CMS rule that would implement stricter auditing standards on Medicare Advantage plans. -
UnitedHealthcare hits back at Prisma Health lawsuit
UnitedHealthcare says it did not breach its contract with Greenville, S.C.-based Prisma Health, and said the health system "coordinated a media effort to put pressure" on the insurance giant. -
UnitedHealthcare's prior authorization cuts begin
The first wave of UnitedHealthcare's prior authorization cuts began Sept. 1.
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Why Blue Shield of California's CEO thinks more payers will leave traditional PBMs behind
Blue Shield of California CEO Paul Markovich won't be surprised if other payers ditch traditional pharmacy benefit managers for a new model. -
Centene in the headlines: 7 recent updates
Centene has moved to divest its overseas businesses and lost out on contract decisions in recent weeks. -
GoodRx launches patient insurance tool for providers
GoodRx has launched a new feature that allows providers to check a patient's insurance benefits when prescribing medications to better understand the final cost. -
Centene reportedly selling last UK business
Centene is planning to sell its Operose clinics in the U.K., its last remaining business in the country, the Financial Times reported Aug. 30.
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The cost of preventing a heart attack with Wegovy? $1M for insurers
Wegovy, Novo Nordisk's expensive weight loss drug, could reduce the risk of cardiovascular events — but at a steep cost to insurers, Bloomberg reported Aug. 31. -
CMS to states: Fix your broken Medicaid eligibility systems
CMS is urging states to correct an issue that could result in eligible people being removed from Medicaid. -
Medicaid in the headlines: 10 recent updates
More than 5 million people have been disenrolled during the Medicaid redeterminations process. In some states, Medicaid recipients have filed legal challenges to the process, and whistleblowers are raising alarms. -
Highmark names CFO of insurance segment
Highmark Health Plans has named Ja'Ron Bridges senior vice president and CFO, effective Sept. 25.
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Inland Empire Health Plan names chief people officer
Inland Empire Health Plan has named Supriya Sood as chief people officer. -
Centene partnering with American Legion on Medicare Advantage plans for veterans
Wellcare, Centene's Medicare Advantage business, is partnering with the American Legion on Medicare Advantage plans designed to complement benefits veterans receive through the VA. -
UnitedHealthcare community plans prior authorization cuts by category
UnitedHealthcare is cutting 20 percent of its prior authorizations in two waves. The first cuts take effect Sept. 1 and the second phase goes into effect Nov. 1. -
Humana's CenterWell expanding to in-home primary care
CenterWell, Humana's older-adult focused primary care business, is expanding to in-home primary care. -
Prisma Health files for temporary restraining order against UnitedHealthcare amid contract negotiations
Greenville, S.C.-based Prisma Health is alleging UnitedHealthcare breached its confidentiality agreement with the system in the midst of contract negotiations. -
Cigna, Valley Children's split
Cigna is out of network with some of Madera, Calif.-based Valley Children's Healthcare's facilities. -
Elevance Health in the headlines: 9 recent updates
Elevance Health has faced legal action and hold-ups to proposed acquisitions in August. -
Regence BCBS Oregon names market president
Regence BlueCross BlueShield of Oregon has named Michael Cole as market president, effective Sept. 8. -
North Carolina Medicaid expansion unlikely in 2023
North Carolina's Medicaid expansion could be delayed until 2024, North Carolina Health News reported Aug. 29.
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