Health Care Service Corp.’s Blue Cross and Blue Shield of Texas and Austin-based Ascension Texas reached an agreement Dec. 31, just ahead of their end-of-year deadline, according to the insurer. Now, all members — spanning commercial, ACA and Medicare Advantage…
Author: Elizabeth Casolo
Affordability is a persistent struggle with employer-sponsored health insurance, according to 2024 data published in December by the University of Minnesota’s State Health Access Data Assistance Center. The data brief relied on the Agency for Healthcare Research and Quality’s Medical…
Negotiated prices for 10 Medicare Part D drugs will go into effect Jan. 1, 2026, which could lead to $1.5 billion in out-of-pocket savings, according to a December AARP Public Policy Institute report. The negotiations stem from the Inflation Reduction…
Asset limits will return to California’s Medicaid, Medi-Cal, next year, and new enrollments are on pause for those lacking “satisfactory immigration status,” according to the state Department of Health Care Services. While income is the only factor for Medicaid eligibility…
Payers are trimming their workforces and cutting jobs due to financial or operational challenges, along with contract losses.
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The Supreme Court of the State of Idaho dismissed Elevance Health subsidiary Carelon’s lawsuit on its eligibility to bid for a mental health contract, according to a Dec. 18 filing. In 2021, the Idaho Department of Health and Welfare solicited…
Navigating GLP-1 coverage for weight loss has been a sore spot for insurers and employers. These drugs — alongside other specialty drug spending — have been behind price hikes going into 2026. Still, as some employers, states and insurers hesitate…
The Alabama Independent Pharmacy Alliance is pushing for transparency from pharmacy benefit managers, focusing on one in particular. The statement, published Dec. 23 in the Alabama Healthcare Examiner, specifically mentions the PBM Prime Therapeutics, which is jointly owned by Blue…
Blue Cross and Blue Shield of Kansas has reached an agreement with Topeka-based University of Kansas Health System St. Francis Campus, also owned by Nashville, Tenn.-based Ardent Health Services, the insurer’s website said Dec. 24. The agreement retains coverage for…
CMS shared plans Dec. 23 for its voluntary “Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth” — or BALANCE — model. The announcement comes weeks following the White House’s agreements with Eli Lilly and Novo Nordisk to apply most-favored-nation…