Today's Top 20 Stories
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Former Aetna Medicaid president named AmeriHealth Caritas CEO
Kelly Munson has been named CEO of AmeriHealth Caritas. -
CMS to terminate Illinois insurer's Medicare Advantage drug plan following low star ratings
CMS is terminating Chicago-based Zing Health's Medicare Advantage prescription drug plan at the end of 2024 following three consecutive years of star ratings below three stars. -
Virginia eliminates tobacco use surcharge under ACA plans
Virginia has banned payers offering coverage on the ACA marketplace from including a surcharge for tobacco use, effective Jan. 1.
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Managed care companies lagged behind other insurers in 2023: S&P
Managed Medicaid and Medicare Advantage insurers economically lagged behind other payers and the wider market in 2023, according to a Jan. 5 analysis from S&P Global Market Intelligence. -
Hospitals, payers get behind key points of CMS' Medicare Advantage proposed rule
Hospital and payer groups were broadly supportive of proposed changes to Medicare Advantage prior authorization and broker compensation regulations. -
What 5 recent studies found about Medicare Advantage
Recent research on Medicare Advantage has tracked competition in local markets and investigated the rates of biosimilar drug uptake in both MA and traditional Medicare. -
CVS Health in 'early innings' of Aetna integration, new president says
Aetna President Brian Kane said CVS Health is still in the "early innings" of integrating the payer into the company, the Hartford Business Journal reported Jan. 8.
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UnitedHealth Group in the headlines: 12 updates
From accusing two former executives of stealing trade secrets to selling its health insurance and hospital operations in Brazil, here are 12 updates on UnitedHealth Group Becker's has reported since Dec. 12: -
California fines Anthem Blue Cross for slow provider payments
The California Department of Managed Health fined Anthem Blue Cross of California $690,000 for failure to reimburse providers and members in a timely manner during the second half of 2021. -
Elevance Health sues HHS over Medicare Advantage star ratings changes
Elevance Health and its insurance subsidiaries are suing HHS for "unlawful, and arbitrary and capricious" methodology changes to how Medicare Advantage and Part D star ratings are calculated. -
Defunct Friday Health Plans ordered to pay co-founder $450K
A Colorado judge ordered defunct health insurance company Friday Health Plan to pay $450,000 to its co-founder David Pinkert, who sued the company for failing to pay his severance after he was fired in 2022, Law360 reported Jan. 3.
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CMS to terminate Medicare Advantage drug contracts with 2 Centene plans
CMS is terminating Centene's WellCare Medicare Advantage prescription drug plans in Arizona and North Carolina at the end of 2024 following three consecutive years of star ratings below three stars. -
The largest Medicare Advantage insurer in every state
UnitedHealth group has the largest Medicare Advantage market share in 25 states, according to the American Medical Association. -
CMS rejected 1 in 3 Medicare Advantage ads in 2023
CMS rejected around a third of proposed Medicare Advantage television ads in 2023, Politico reported Jan. 5. -
CVS' 2024 Medicare Advantage growth exceeds expectations
CVS Health beat its expectations for growth during Medicare Advantage open enrollment, the company said. -
The cities with the least competitive commercial insurance markets | 2023
Blue Cross Blue Shield of Alabama has more than 90% of the commercial and exchange insurance market share in three cities in the state, the most highly concentrated markets in the U.S., according to the American Medical Association. -
Medicare Advantage in the headlines: 9 recent updates
Several mergers and acquisitions are afoot in Medicare Advantage. -
Payer M&A deals to watch in 2024
The new year has just begun, but already a significant payer transaction reportedly is in the works. -
Memorial Hermann drops Humana Medicare Advantage
Houston-based Memorial Hermann Health System is no longer in network with Humana's Medicare Advantage plans, effective Jan. 1. -
Centene spent $307M to settle state overbilling allegations in 2023
A settlement agreement with South Carolina in late December brought the total amount that Centene paid in 2023 to resolve allegations it overbilled state Medicaid programs for pharmacy services to $307 million.
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