Today's Top 20 Stories
  1. Pennsylvania prior authorization reform bill signed into law

    Pennsylvania Gov. Tom Wolf on Nov. 3 signed a bill aiming to streamline the prior authorization process. 
  2. 'Simply false and wrong': AHIP rebukes AMA Medicare Advantage market report

    AHIP is pushing back on claims that Medicare Advantage markets are uncompetitive, calling a recent report from the American Medical Association "simply false and wrong." 
  3. How BCBS of Tennessee keeps winning 'best places to work' accolades

    BlueCross BlueShield of Tennessee might be the best health insurance company to work for.  The Chattanooga, Tenn.-based payer has received a laundry list of accolades for employee satisfaction and diversity, equity and inclusion, including being named among the top workplace for women, among the nation's most diverse employers, and being rated the best employer in Tennessee.

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  1. Losing bidder's protest delays Nebraska Medicaid contract signing

    Nebraska has delayed the signing of new Medicaid managed care contracts until a protest filed by a losing bidder is resolved, the Omaha World-Herald reported Nov. 6. 
  2. MHS Health Wisconsin names CEO

    MHS Health Wisconsin has named Titus Muzi Jr. as president and CEO.
  3. Texas asks Friday Health Plans to leave ACA marketplace

    Friday Health Plans will not offer coverage on the ACA marketplaces in Texas and New Mexico for 2023, The Alamosa Valley Courier reported Nov. 4.
  4. Touting growth, sweating star ratings: What payer CEOs said about Medicare Advantage this fall

    Medicare Advantage open enrollment is underway, and payers are expecting to see even more older adults choose the plans over traditional Medicare. 

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  1. BCBS Illinois, Springfield Clinic dispute still unresolved 1 year later

    Nearly a year after contract negotiations between Blue Cross Blue Shield of Illinois and Springfield Clinic fell through, the two sides are still negotiating without a resolution in sight, WCIA reported Nov. 3.
  2. CVS expecting $2B revenue hit from star ratings decline, loss of Centene pharmacy contract 

    CVS Health executives told investors Nov. 2 the company is expecting a $2 billion decline in 2024 revenues because of its lower Medicare Advantage star ratings in 2023 and the loss of its pharmacy benefits contract with Centene.
  3. 'Do you not see this as an arms race?' Cigna CEO questioned on M&A activity

    Cigna's CEO David Cordani addressed questions from investors Nov. 3 over concerns the company is falling behind other insurers by not pursuing major mergers or acquisitions. 
  4. Strategies for addressing 'Medicaid churn': Viewpoint

    Millions of people are expected to lose Medicaid coverage when the federal public health emergency ends. This challenge presents an opportunity for states to address the issues of "Medicaid churn," researchers at New York City-based New York University and Boston-based Harvard T.H. Chan School of Public Health write in a Nov. 3 JAMA Health Forum paper. 

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  1. Alameda Alliance for Health CEO to retire

    Alameda Alliance for Health CEO Scott Coffin is retiring, effective May 31, 2023.
  2. Alignment Healthcare's losses continue to shrink as market share grows

    Alignment Healthcare's overall losses are continuing to improve as the Medicare Advantage provider adds members and offerings. 
  3. Centene uses subsidiaries to amplify political donations, report says

    Centene has donated to political candidates in states where it is up for Medicaid contract selection or defending itself against overbilling accusations, sometimes through multiple subsidiaries, according to a Kaiser Health News report published Nov. 4. 
  4. Cigna spending $200M to integrate Express Scripts with Centene

    Cigna is spending $200 million to integrate Express Scripts as Centene's new pharmacy benefit manager for 20 million members starting in 2024.
  5. Q&A: Elevance Health's first health equity officer on partnering with Harvard to address Medicaid inequities

    Darrell Gray II, MD, is the inaugural chief health equity officer at Elevance Health, where he's now spent just over one year leading a company-wide strategy to advance health equity for 45 million members.
  6. L.A. Care Health Plan nabs Oscar Health's chief medical officer

    L.A. Care Health Plan, the nation's largest publicly operated plan, has named Sameer Amin, MD, as its next chief medical officer, effective Dec. 5.
  7. Senate report pushes more Medicare Advantage rules because of 'misleading and aggressive' marketing

    Senate Finance Committee Democrats are pushing for tighter regulation of Medicare Advantage marketing from CMS and Congress. 
  8. 1 in 3 people transition insurance after giving birth: Study

    More than 1 in 3 beneficiaries transition insurance 12 months before or after giving birth, a study published in JAMA Network Open Nov. 3 found. 
  9. 6 recent payer workforce moves

    Some payers are abandoning office spaces, while others are opening them, as remote and hybrid work modes remain a popular option for employees. Here are six payer workforce updates Becker's has reported since Sept. 4. 

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