Author: Jakob Emerson

Cleveland Clinic is working to get New York state to conduct an independent external review of a Bronx man's rare cancer diagnosis and recommended multi-organ transplant after Empire Blue Cross Blue Shield denied coverage, WPIX reported July 12.

West Virginia University Medicine's new Peak Health plan will become a Medicare Advantage and Medicaid managed care provider in the state, MetroNews reported July 12.

Aetna has dropped its policy to not cover cardiac PET/CT scans following a joint letter from the American Society of Nuclear Cardiology and the Society of Nuclear Medicine and Molecular Imaging.

XSOLIS has named Jamie Kiggen CFO and Michael Drescher as vice president of payer strategy.

Florida's Department of Management Services is now accepting bids from payers to manage its $3.12 billion state employee health plan that covers about 170,000 people, according to Florida Politics.

San Diego-based Turquoise Health and San Francisco-based Komodo Health are partnering to create a platform that will allow patients to understand the full cost of healthcare services and help streamline payer-provider contracts.

The majority of fee-for-service Medicare and Medicare Advantage members largely don't understand their coverage policies, leading to the widespread risk of enrollees who are in plans that don't fit their health or financial needs, according to a new report from…

UnitedHealthcare affiliate Bind is changing its name to Surest, with the full rollout expected to be completed Jan. 1, 2023.

Though the U.S. health insurance industry saw gains in 2021, underwriting profits declined 65 percent to $23.9 billion, according to a report published July 6 by AM Best.

Pharmacy benefit managers help bring medication costs down and improve care outcomes, but they are being scapegoated for the nation's high drug prices, an op-ed published July 11 in the The Wall Street Journal argues.