A woman is suing Elevance Health after being denied coverage for Zepbound — Eli Lilly’s weight-loss drug — to treat her sleep apnea, a court filing said. According to the complaint, the FDA approved Zepbound “as the first and only…
Author: Elizabeth Casolo
Blue Cross Blue Shield of Massachusetts has hired Sophie Clarke, MD, as chief strategy officer and senior vice president, according to a Sept. 18 news release. Dr. Clarke’s role will focus on corporate strategy, along with identifying companies to fund…
Hawaii Medical Service Association and Blue Cross and Blue Shield of Kansas joined Blue Shield of California as co-founders of Stellarus, according to a Sept. 18 news release from the technology company. Stellarus said it aims to help health plans…
Marketplace enrollment soared at over 24 million plan selections for 2025, but the enhanced premium tax credits that enabled this surge are set to expire at the end of the year. Some 4.8 million people total will lose their insurance…
The National Committee for Quality Assurance identified the standout MA plans for each state, evaluating based on nearly 50 factors that include patient experience and clinical performance. The ratings were released Sept. 16 and are based on 2024 data from…
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Elevance Health filed a complaint Sept. 12 against a former senior underwriting executive who took another job at a competitor despite having signed a noncompete agreement. According to the lawsuit, which was reviewed by Becker’s, Maria Gregory started a position…
Three Medicare Advantage plans scored a full five stars in this year’s health plan rankings from the National Committee for Quality Assurance. An additional 17 plans, including six more Kaiser Foundation Health Plans from around the country, scored 4.5 stars…
The National Committee for Quality Assurance has named the highest-quality and most-effective health plans of 2025 based on nearly 50 factors that include patient experience and clinical performance. The ratings were released Sept. 16 and draw on 2024 data from…
Aetna’s new “level of severity inpatient payment” policy will take effect in less than two months, and the American Hospital Association said it is “deeply concerned.” Aetna’s policy, set to go into effect Nov. 15, will approve inpatient stays without…
Robert Andrews — a former congressman and the CEO of the Health Transformation Alliance, a cooperative of self-insured companies — predicts AI will be able to personalize formularies for patients within five years. “Formularies are really built upon economic, commercial…