Author: Elizabeth Casolo

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.

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…

Prior authorization was a hot topic in 2025, from insurers pledging reforms to a Medicare pilot on the horizon. Here are five of the biggest stories on prior authorization from 2025: 1. Payers have been working toward meeting requirements for…

The Board of County Commissioners in Multnomah County, Ore., approved $2.4 million Dec. 11 to partially address a $4.6 million budget gap left when the state’s largest Medicaid provider, CareOregon, rolled back spending for behavioral healthcare, according to a Dec.…

Health insurance is the most-valued employee benefit among U.S. workers, according to a Dec. 4 report from Indeed’s Hiring Lab. The findings are based on Indeed’s 2025 Workforce Insights Survey, which polled 80,936 adults between May and June across eight…