Author: Rylee Wilson

A group of 35 state attorneys general signed on to an amicus brief supporting Oklahoma's laws regulating pharmacy benefit managers, published Oct. 18. 

Cigna will offer plans on the ACA marketplace in four South Carolina counties for 2023, the payer said Oct. 19. 

The council of the District of Columbia voted to approve awarding Medicaid contracts to Amerigroup, MedStar Family Choice and AmeriHealth Caritas D.C., despite protests from CareFirst Blue Cross Blue Shield, The Washington Post reported Oct. 18. 

Payer-negotiated prices for radiology services can vary widely, even within the same hospital, a study published Oct. 18 in Radiology found. 

Enrollees in ACA marketplace plans hit record highs in 2022, a Kaiser Family Foundation analysis published Oct. 17 found. 

Deadlines are looming in some payer-provider contract disagreements, while other ongoing negotiations are leaving members out of network.

The American Arbitration Association, the largest provider of arbitration and mediation services, has updated its rules for mediating payer-provider disputes, the association said Oct.18. 

Most city- and state-level commercial prescription drug markets are highly concentrated, with one pharmacy benefit manager controlling a large share of the market, a report published Oct. 13 by the American Medical Association found. 

CMS is considering adding more qualifying conditions for Medicare-covered dental treatment, Kaiser Health News reported Oct. 17. 

California's first-ever Medicaid managed contract procurements are a major shakeup in the state's Medi-Cal system, which has over 12 million enrollees, or a third of California's population.