Author: Rylee Wilson

The Pennsylvania Insurance Department fined Highmark Inc. $205,000 for violations including incorrectly denied claims, untimely payments and violations of mental health parity requirements. 

The reason for most in-network claim denials in ACA plans is not reported in price data, according to an analysis from Kaiser Family Foundation. 

UnitedHealthcare has the most Medicare Advantage members among large payers, while MA makes up a relatively small slice of Cigna's business. 

New York state legislators and stakeholders are debating a bill that would overhaul the state's health system and establish a single-payer system, Spectrum News reported Feb. 9. 

Traditional Medicare and Medicare Advantage beneficiaries could begin seeing lower copays for certain Part B drugs beginning April 1, according to new guidance from HHS. 

Payer executives are expecting to lose members in their Medicaid managed care contracts as states begin the redetermination process, but some are hopeful to convert some of these members to other lines of business. 

Several insurers and health systems have reached agreements to keep members in network in February. 

Health Net Federal Services, a Centene subsidiary, is challenging the Defense Department's decision to hand over management of a Tricare contract to TriWest Healthcare Alliance, military.com reported Feb. 9. 

Minnesota lawmakers are considering a bill to expand MinnesotaCare, the state's program for those with low incomes, to all residents, the Pioneer Press reported Feb. 8. 

Insurers denied around 17 percent of in-network claims for ACA Exchange plans in 2021, according to an analysis from Kaiser Family Foundation.