Today's Top 20 Stories
  1. 'Modern gangsters': Ohio sues 3 PBMs for alleged price fixing

    The Ohio attorney general's office has filed a lawsuit against three pharmacy benefit managers, accusing them of sharing pricing and other information gathered by a Swiss subsidiary to gain leverage during negotiations with drugmakers for rebates, The Wall Street Journal reported March 27. 
  2. 'A turning point': Inside the federal push to measure social determinants for the first time

    CMS is in the process of creating a "universal foundation" of quality measures, setting the stage for the first time the federal government has tracked social determinants of health across all of its healthcare programs.
  3. Prime Therapeutics names Magellan Rx CEO as president

    Prime Therapeutics appointed Mostafa Kamal as president of the organization. 

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  1. CMS' Medicare Advantage coding changes could hurt dual-eligible members, health plan leaders say

    Nonprofit payer executives are urging CMS to pause its proposed changes to Medicare Advantage to ensure coding updates will not harm dual-eligible MA members. 
  2. AHIP backs HHS in challenge to agency's copay coupon policies

    AHIP is backing an HHS policy that allows insurers not to count copay coupons toward out-of-pocket maximums. 
  3. Price transparency means the end of payer-provider 'information asymmetry,' Trilliant CEO says

    Value-based care isn't yet scaling, but price transparency could bring about widespread value-based competition, Trilliant Health CEO Hal Andrews says. 
  4. BCBS Minnesota vacating 443K-square-foot headquarters

    Blue Cross and Blue Shield of Minnesota is the latest payer cutting back on office space, planning to vacate its headquarters in Eagan, Minn., the StarTribune reported March 24. 

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  1. Kansas lawmakers weighing prior authorization reforms

    Kansas lawmakers are considering legislation backed by the Kansas Hospital Association that would reform the prior authorization process.
  2. Why some retirees are wary of employer Medicare Advantage plans

    After a yearslong bureaucratic battle, New York City officials approved an Aetna Medicare Advantage plan for its retired municipal employees, though the plan could be headed for more court battles. 
  3. 'They pulled a Silicon Valley Bank': Regulatory questions swirl in health insurance

    Two states have now publicly said they are in direct control of Bright Health's financial operations, prompting questions around whether insurance regulators are prepared to protect consumers from startup health plans with uncertain futures.
  4. Kentucky governor vetoes attempt to scrap expanded Medicaid benefits

    Kentucky Gov. Andy Beshear has vetoed a bill passed by the state's Legislature that would throw out expanded dental, vision and hearing coverage for 900,000 adults on Medicaid, the Louisville Courier-Journal reported March 24. 

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  1. Payers can't meet Colorado's public option price targets

    Several payers said it will be impossible to meet Colorado's price targets for its Colorado Option program in 2024, The Colorado Sun reported March 24. 
  2. New Jersey lawmaker resigns for spot on Horizon Blue Cross board

    New Jersey assemblyman Ralph Caputo resigned his seat in the state's legislature to take a position on the board of Horizon Blue Cross Blue Shield, reported March 23. 
  3. Meet Oscar Health's leadership team

    Oscar Health named former Aetna CEO Mark Bertolini its next chief executive, effective April 3. Here is more information about Mr. Bertolini and the other executives that make up the insurtech company's leadership team according to the company's website and their LinkedIn pages: 
  4. UnitedHealthcare, U of Vermont Health extend contract through end of 2023

    UnitedHealthcare and Burlington-based University of Vermont Health Network have reached an agreement to extend their current contract agreement through Dec. 31, avoiding a split set to take effect April 1. 
  5. Senators question payer execs on 'outrageous' Medicare Advantage profits

    Two senators are questioning insurers' claims that proposed Medicare Advantage rates would cut member benefits. 
  6. Humana's 5 highest-earning executives

    Humana's highest paid employee is President and CEO Bruce Broussard, who had a total compensation of $17.2 million in 2022, according to regulatory documents filed March 8.
  7. Tennessee takes control of Bright Health's finances

    Tennessee is the second state to publicly say it has taken control of Bright Health's financial operations.
  8. Reducing Medicare Advantage benchmark payments will slightly reduce benefits, study finds

    Reduced Medicare Advantage benchmark payments would likely have a small effect on premiums, cost-sharing and benefits offered by MA plans, a study published March 22 in Health Affairs found. 
  9. North Carolina 1 signature away from being 40th state to expand Medicaid

    The North Carolina House has passed a Medicaid expansion bill, which now heads to the governor, who has indicated he will sign it into law, the Greensboro News & Record reported March 23.  

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