Author: Rylee Wilson

Health Net is launching a "review to renew" campaign to inform its millions of Medicaid members in California about upcoming redeterminations. 

Centene has agreed to pay Indiana more than $66 million to settle allegations it overbilled the state's Medicaid program for pharmaceutical services. 

BlueCross BlueShield of Tennessee has completed its first annual health equity report and will use the findings as a benchmark to drive further progress, Andrea Willis, MD, chief medical officer for BCBS Tennessee, said in the Tennessean Jan. 26. 

Medicare Advantage plans will face tougher auditing standards after a highly-anticipated ruling from CMS. The program also hit 30 million members in recent weeks, and payers are expecting enrollment numbers to keep climbing. 

Organizations representing payers say tougher auditing standards CMS will impose on Medicare Advantage plans could create higher premiums and fail to target fraud. Others say the new rule, which eliminates the fee-for-service adjuster, doesn't go far enough. 

New Mexico has canceled its current Medicaid contract procurement process as the state's Human Services Department director and Medicaid director depart. 

Molina Healthcare named Frank Clepper as plan president for the payer's Nebraska operations. 

CMS will implement stricter audits of Medicare Advantage plans, a move that could leave payers on the hook for billions of dollars in repayments to the federal government. 

HHS is proposing a new pathway for no-cost contraceptive coverage for employees of organizations with religious objections to covering these services. 

Payers are investing in social determinants of health and health equity for members and communities.