Nevada Gov. Joe Lombardo and the Nevada Department of Health and Human Services have announced the launch of the Nevada Health Authority, effective July 1. The NVHA consolidates the state’s Medicaid program, ACA exchange, and public employees’ benefits program under…
Author: Jakob Emerson
Elevance Health has agreed to a $12.9 million settlement to resolve a class action lawsuit that accused the company of improperly denying coverage for residential treatment of mental health and substance use disorders. The lawsuit was originally filed in April…
Ohio ended GLP-1 coverage for weight loss under its state employee health plan on July 1. Any current prior authorizations for medications will be honored until they expire, and GLP-1 medications prescribed for diabetes will continue to be covered. Several…
Representatives from Anthem Blue Cross Blue Shield and Columbia-based University of Missouri Health Care testified before a state committee on June 30 regarding a disagreement over reimbursement rates. Since April, MU Health Care’s physicians and facilities have been out of…
Several major health systems and insurers went out of network on July 1. Contract disputes between insurers and health systems are down in 2025 compared to the second half of 2024. In the first quarter of 2025, 26 total disputes…
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Blue Shield of California is cutting broker commissions for new enrollments into Medicare Advantage PPO plans in Alameda, Orange and San Diego counties, effective July 1. The new policy does not affect commission payments of existing membership, according to a…
Wisconsin Physicians Service Insurance Corporation is laying off 51 employees in Madison and Monona due to competitive pressures. The layoffs will begin to take place on Sept. 30, according to regulatory documents filed with the state June 27. Madison-based WPS…
An Ohio state judge has temporarily barred a Texas-based insurer that sold health insurance plans to retired law enforcement and fire personnel from operating in the state due to violations of insurance laws. On June 25, a Franklin County judge…
Louisiana Gov. Jeff Landry has vetoed a key provision from the state’s budget plan that would have required coverage of weight loss medications for state employees and their dependents for the upcoming fiscal year, citing concerns over long-term costs. The…
Ahead of the health insurance industry’s broader pledge to overhaul prior authorization processes, one Texas payer has already achieved a 7% prior authorization denial rate, with 100% of those denials upheld upon appeal. On June 23, nearly 50 insurers committed…