Author: Elizabeth Casolo

Oklahoma Attorney General Gentner Drummond challenged the state’s managed care Medicaid in an Oct. 22 letter to the Oklahoma Health Care Authority, the agency that oversees the program. Mr. Drummond said providers have concerns about pediatric patient care, such as…

Elevance Health has shared plans to potentially penalize hospitals and other contracted facilities that use care providers who are not in-network with its Anthem Blue Cross Blue Shield commercial plans in 11 states. Under the policy, finalized Oct. 1 and…

James Brown, Montana state auditor and commissioner of securities and insurance, launched an investigation into Blue Cross and Blue Shield of Montana, a subsidiary of Health Care Service Corp., after a data breach that may have affected up to 462,000…

Coverage for drugs recently approved by the FDA can take months to solidify, according to the Institute for Clinical and Economic Review’s “Launch Price and Access Report,” published Oct. 23. Researchers reviewed 24 drugs from Boston-based Tufts Medical Center’s specialty…

CMS Administrator Mehmet Oz, MD, told FOX 5 Atlanta that the government shutdown is not affecting Medicare open enrollment. “The shutdown is a problem for lots of parts of government but not for [Medicare] open enrollment,” he said. “Medicare is…

The high cost of GLP-1 drugs have thrown a curveball at payer strategy. Employers providing health insurance are also grappling with the fallout. From January to July, Davis Research interviewed business owners and human resource and benefits managers at 1,862…

Los Angeles-based Cedars-Sinai and Anthem Blue Cross of California are extending their contract until Jan. 1, 2030, the health system said in a news release shared with Becker’s. More than 230,000 Anthem members will stay in network under the multiyear…

In 2025, the average annual premium for family health insurance reached $26,993, according to KFF’s employer health benefits survey. From January to July, Davis Research interviewed business owners and human resource and benefits managers at 1,862 firms for the survey.…

SCAN Health Plan and Costco Wholesale Corp., a preferred pharmacy for the insurer, are collaborating to offer older adults a rewards program, provide them with greater flexibility with spending benefits and educate them about Medicare. Senthu Arumugam, SCAN’s chief commercial…

UnitedHealth’s Optum has launched Optum Real, a real-time claims system designed to streamline the claims and reimbursement process by providing instant coverage validation for providers. “Optum Real transforms the pre-service experience in real time by delivering greater clarity and certainty…