Author: Jakob Emerson

The Blue Cross Blue Shield Association has named Razia Hashmi, MD, as vice president of clinical affairs.

Grocery delivery company Instacart is launching a co-branded Medicare Advantage plan next year with Alignment Healthcare in 13 counties across California and Nevada.

With bipartisan support in Congress and a record number of plans offered nationwide, Medicare Advantage is growing fast, diversifying its members and driving senior care costs down, according to the Better Medicare Alliance's 2023 "State of Medicare Advantage Report."

As the Medicare open enrollment period approaches, the nation's largest insurers are expanding Medicare Advantage plans to nearly every corner of the country, along with introducing plans built for specific populations.

The Cigna Group will pay $172.3 million to resolve allegations that it violated the False Claims Act by submitting incorrect Medicare Advantage patient data to CMS to receive higher payments from the agency.

The Massachusetts Laborers' Health and Welfare Benefit Fund is suing Blue Cross Blue Shield of Massachusetts again for allegedly overcharging for healthcare and administrative services as the fund's third-party administrator. 

Cincinnati-based Bon Secours Mercy Health and Anthem Blue Cross and Blue Shield have reached a contract agreement through 2028, ending one of the more public payer-provider reimbursement disputes of this year.

UCare has selected Navitus Health Solutions, a pharmacy benefit manager owned by St. Louis-based SSM Health and Costco, to administer pharmacy benefits to its more than 600,000 members across all lines of business, effective Jan. 1.

Among the major payers, customers are most satisfied with the telehealth offerings from UnitedHealthcare and Kaiser Permanente, according to the "J.D. Power 2023 U.S. Telehealth Satisfaction Study."

New Hampshire is looking for payers to administer its Medicaid managed care program starting next year.