There's a lack of commercial coverage for digital healthcare services compared to publicly-funded health plans, which is limiting access to care for more than half of the U.S. population, according to new research published by the AMA on Sept. 19.

Updated COVID-19 boosters have started rolling out to pharmacies nationwide, but some individuals are reporting a high price tag associated with getting a shot.

Elevance Health's pharmacy benefit manager, CarelonRx, is launching a new integrated cost savings program to automatically offer members the lowest price for generic prescription drugs while at their preferred pharmacy.

Bright Health owes CMS $380 million in risk adjustment payments from its shuttered insurance business, the company said Sept. 19. 

Medicare Advantage beneficiaries with Alzheimer's disease and related dementia are 1.4 times more likely to switch to traditional Medicare than their counterparts without the disease, a study published Sept. 15 in JAMA Health Forum found. 

Magellan Health, a subsidiary of Centene, has named Arthur Hennig as senior vice president and chief business officer for payer markets and Sara Pierce as senior vice president and chief business officer for the employer market.

Former Cigna employee Jonathan Ferrie will pay more than $33,000 to settle insider trading allegations from the U.S. Securities and Exchange Commission. 

Greater access to care and making such care more affordable may be on the horizon for lower-income older adults and people with disabilities after the Department of Health and Human Services and CMS finalized a rule to streamline enrollment in the Medicare Savings Programs. The move was described in a Sept. 18 news release as the most significant HHS action in a decade for such care.

Aetna has filed to offer individual health plans on the Maryland ACA exchange in 2024.

AmeriHealth Caritas has named Melody Bonomo as Florida market president. 

North Carolina lawmakers are proposing tying funding to expand the state's Medicaid program to a bill approving four new casinos in the state, the News and Observer reported Sept. 18. 

Oregon is asking CMS to approve a basic health program for lower-income individuals who make too much to qualify for Medicaid, a move that could raise premiums prices on the state's individual insurance market. 

From several new Blue Cross Blue Shield CEOs to a shakeup at Optum, these are 18 payer CEO moves reported by Becker's since Jan. 1:

New York's Medicaid program paid $388 million for medical services between 2016 and 2022 that should have been paid by federally-funded plans such as Medicare, according to two audits from the state's comptroller published Sept. 14.

Blue Cross and Blue Shield of Texas is partnering with Huston-Tillotson University, a historically Black university in Austin, Texas, on a new program aimed at educating doulas. 

Cigna Healthcare is offering employers a supplemental benefit designed to help employees diagnosed with musculoskeletal conditions. 

CVS Health said it will lay off over 500 Aetna employees in the coming weeks, and the company welcomed a new president of Aetna in September. 

UnitedHealthcare and Cigna's prior authorization cuts are steps in the right direction, but the American Medical Association is "careful not to confuse positive developments with major progress," the organization's immediate past president Jack Resneck, MD, said. 

A federal policy change has allowed Nevada reinstate Medicaid coverage to 114,000 residents who lost coverage because they did not return their renewal documentation. 

UnitedHealth Group will move from its headquarters building in Minnetonka, Minn., to Optum's campus in Eden Prairie, Minn., in 2024, the Minneapolis/St. Paul Business Journal reported Sept. 18.