Today's Top 20 Stories
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8 payers sign on to Washington's value-based care pact
Eight payers have signed an agreement to promote value-based payment models in Washington state. -
Arrests made during protest outside UnitedHealthcare headquarters
Eleven people were arrested July 15 during a protest outside UnitedHealthcare's headquarters in Minnetonka, Minn., the Star Tribune reported. -
Court sides with Aetna over BCBS for North Carolina state health plan
A North Carolina state court has sided with the state in its decision to award Aetna its health plan contract for public employees over Blue Cross Blue Shield of North Carolina.
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BCBS and Medicare Advantage: 7 updates
From new star ratings to market departures, these are seven recent Blue Cross Blue Shield updates involving Medicare Advantage: -
Elevance Health plans primary care clinic partnership
Elevance Health struck a deal with Astrana Health to operate clinics for Anthem Blue Cross members in California. -
Centene board beats $1.3B Medicaid fraud lawsuit
Current and former Centene board members, along with former senior executives, have beat a pension fund derivative lawsuit alleging the company overbilled state Medicaid programs for pharmacy services. -
Trial underway in Florida Medicaid redeterminations challenge
A trial is underway to determine if Florida failed to properly notify Medicaid beneficiaries it disenrolled during the unwinding process, the Miami Herald reported July 11.
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CMS cites Aetna in 1st No Surprises Act audit
Aetna failed to accurately calculate qualified payment amounts for air ambulance services, CMS' first audit of an insurer's No Surprises Act compliance found. -
AI a higher investment priority for payer CFOs
Investing in digital and artificial intelligence technologies is a higher priority for payer CFOs than for their health system counterparts, according to a July 10 report from Deloitte. -
Highmark loses 26,000-member contract
The largest health insurance purchaser in Western New York will award its employee health plan to Univera Healthcare, Buffalo News reported July 11. -
Medicare Advantage in the headlines: 10 recent updates
CMS published updated star ratings for dozens of Medicare Advantage plans, and a federal judge paused a new CMS regulation that would cap the amount insurers can pay brokers who sell their plans.
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Illinois gov. signs prior authorization reform bill
Illinois Gov. JB Pritzker has signed a pair of health insurance reform bills into law. -
BCBS Louisiana switches to Epic
Blue Cross and Blue Shield of Louisiana has moved its care management processes and several provider services to the Epic Payer Platform. -
The 'old-fashioned' weight loss method being embraced by insurers
As insurers continue to face major financial pressures related to covering weight loss drugs, many are steering more patients toward bariatric surgery to achieve similar results. -
Florida system's primary care physicians splitting with BCBS Medicare Advantage
Fort Myers, Fla.-based Lee Health's Physician Group primary care providers will be out of network with Florida Blue's Medicare Advantage plans by September. -
SCAN Group names 5 new execs
SCAN Group has appointed five new executives, including a chief technology officer and chief marketing officer, to grow its Medicare Advantage business. -
UnitedHealth Group, officials sued over Justice Department probe
UnitedHealth Group and several of the company's leaders are facing a shareholder derivative lawsuit alleging they failed to disclose that the Justice Department opened an antitrust investigation into the company. -
Kansas rejects Aetna's Medicaid challenge
The Kansas Department of Administration rejected challenges to the state's Medicaid contract procurement process from Aetna and CareSource, the Kansas Reflector reported July 8. -
The 'critical success factor' behind BCBS Michigan's Medicare Advantage program
Medicare Advantage organizations are facing major challenges, including rising utilization rates, reduced reimbursements, and an evolving regulatory landscape. -
AI a boost for BCBS Illinois customer service
To enhance its customer service, Blue Cross Blue Shield of Illinois is looking to artificial intelligence.
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