Today's Top 20 Stories
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Tougher rules needed for Medicare Advantage AI, 51 lawmakers say
Lawmakers are pushing CMS to do more to prevent misuse of artificial intelligence by Medicare Advantage plans. -
17 payer executives' top priorities for the 2nd half of 2024
Payer executives are focused on improving member experience and engagement, implementing value-based models and controlling rising costs in the second half of 2024. -
How a New York payer has avoided Medicare Advantage tensions with hospitals
As large national Medicare Advantage carriers face financial headwinds and tensions with health systems, one New York payer says business in the market is booming.
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Extending ACA subsidies would cost $355B, CBO finds
Making expanded ACA subsidies permanent would add $335 billion to the national deficit between 2025 and 2034, the Congressional Budget Office estimated. -
UnitedHealth exec departs for transplant organization
NMDP has picked up two former payer executives. -
Key union pulls support for NYC's Aetna Medicare Advantage plan
New York City's teachers union has pulled support for the city's shift to Medicare Advantage, further complicating the controversial effort, the New York Daily News reported June 24. -
CareFirst BCBS names VP of state government affairs
CareFirst Blue Cross Blue Shield has named Kimberly Robinson vice president of state government affairs.
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BCBS and weight loss drugs: 5 updates
Some Blue Cross Blue Shield companies say weight loss drugs have played a part in recent financial challenges, and one plan has made the decision to roll back benefits. -
Elevance's Carelon names president
Bryony Winn has been named president of Carelon Health, the health services arm of Elevance Health. -
6 payers among best companies to work for, per US News
Six payers were named in U.S. News & World Report's list of the Best Companies to Work For in 2024-2025. -
CMS to put $500M toward ACA navigators
CMS will put $500 million over the next five years toward navigators designed to help people navigate the ACA exchange, the largest investment in the program to date.
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Excellus BCBS names regional president
Excellus BlueCross BlueShield has appointed Tony Vitagliano as regional president of the payer's Utica market. -
Optum's California president departs for post-acute provider
Post-acute care provider, AccentCare, has named Chris Mayne as president of its home health division. -
Supreme Court rejects challenge to $2.7B BCBS settlement
The U.S. Supreme Court has declined to hear Home Depot's challenge to a $2.67 billion settlement with Blue Cross Blue Shield companies, ending a legal saga over alleged anticompetitive behavior that dates back to 2012. -
Blue Shield of California fires executive over alleged false credentials
Blue Shield of California has fired a top executive for allegedly lying about her medical credentials, a spokesperson for the company told Becker's. -
Court keeps ACA preventive care mandate in place
A federal court kept the ACA preventive care mandate in place for now but raised questions about its constitutionality. -
Washington state opens health coverage to noncitizens
Washington state opened applications for its Medicaid-like health insurance program for undocumented adult immigrants on June 20. -
Fitch: Medicaid pressures likely short-term
Some of the nation's largest health insurers have signaled significant headwinds in recent months within their Medicaid businesses as costs rise and the effect of redeterminations takes hold, but Fitch analysts expect those headwinds to be short-lived. -
Why Blue Shield of California, Included Health put $464M on the line with state contract
The California Public Employees’ Retirement System awarded its PPO contract to Blue Shield of California, the first time the contract has changed hands in 20 years. -
The policies states want to keep after Medicaid redeterminations
The majority of state Medicaid directors want to keep some of the temporary flexibilities CMS introduced during the redeterminations process, according to KFF.
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