Blue Shield of California officials attended an April 8 hearing with the San Francisco Board of Supervisors regarding care denials for workers. The hearing followed reporting from the NBC Bay Area investigative unit that featured a local firefighter who was…
Author: Elizabeth Casolo
It is no secret that prior authorization has long been a sore subject between payers and providers. In June 2025, insurers committed to easing prior authorization requirements. Now, AHIP (formerly American’s Health Insurance Plans) and the Blue Cross Blue Shield…
Arkansas BCBS promoted Vice President of Infrastructure Operations David Martin to CIO earlier this year, according to an April 7 news release shared with Becker’s. Mr. Martin will lead the planning, delivery, cybersecurity and performance of the insurer’s technology. In…
In 2024, the uninsured rate grew for the first time since 2019, according to an April 9 KFF issue brief. KFF reviewed data on uninsured trends and demographics in recent years, focusing on individuals under 65 years old. Following a…
Fallon Health Senior Vice President Anthony Consolmagno has taken over the CFO role in a permanent capacity after serving a stint as the interim CFO, the insurer confirmed to Becker’s April 10. The change took effect Feb. 9. As CFO,…
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Independence Health Group, the parent company of Independence Blue Cross, posted a $423 million net loss in 2025, according to an April 9 news release. Independence attributed the loss to “increased affordability pressure,” citing higher utilization, care complexity and pharmacy…
Medicare supplement enrollment grew 1.3% between 2023 and 2024, according to an April report from AHIP, formerly known as America’s Health Insurance Plans. Medicare supplement, or Medigap, is private insurance for original Medicare beneficiaries to fill in coverage gaps. AHIP,…
Virginia Democratic Gov. Abigail Spanberger signed HB736 into law April 6, furthering prior authorization reform in the state. Effective in 2027, the law establishes a minimum duration requirement. Prior authorizations must be in effect for at least six months for…
Priority Health is estimated to have collected at least $4.4 million in Medicare Advantage overpayments throughout 2018 and 2019, according to a March audit from the HHS Office of the Inspector General. The audit focused on 10 high-risk diagnosis groups.…
Nebraska will roll out Medicaid work requirements in May, making it the first expansion state to implement these provisions under HR 1. Here are four notes leading up to Nebraska’s launch: 1. Medicaid expansion states must implement community engagement requirements…