Author: Staff

UnitedHealth Group is beginning to act on its November promise to shore up its sustainability efforts by halting its mailing paper of prior authorization and clinical decisions to providers, according to a Feb. 25 post on the California Medical Association…

Payer are setting a double standard for patient care that both pushes for centralized, coordinated care and pulls patients away from receiving care in one place, according to Tim Maloney, vice president of payer relations at UC Health in Cincinnati…

The FTC is requesting large, vertically-integrated players in the pharmacy benefit management industry share insights on their influence over drug pricing and access. 

Physicians for a National Health Program is calling CMS' new Accountable Care Organization Realizing Equity, Access, and Community Health Model "direct contracting in disguise," according to a Feb. 24 news release shared with Becker's. 

BlueCross BlueShield of Texas has until Feb. 28 to strike up a new network agreement with Houston-based Memorial Hermann Health System, according to Click2Houston. 

UnitedHealth Group's pharmacy benefit manager OptumRx is settling with the state of Massachusetts over claims that it failed to follow prescription pricing procedures, attorney general Maura Healey announced Feb. 24. 

Centene Chairman and CEO Michael Neidorff will be taking a medical leave of absence, effective Feb. 24. 

A Kentucky judge ruled in favor of Anthem BlueCross & BlueShield after a transgender member accused the payer of unjustly denying coverage of gender-affirming facial surgery, according to Bloomberg Law. 

Since the implementation of the ACA, uninsured rates for Black Americans have dropped 40 percent, according to a Feb. 23 HHS report. 

Clover Health hit nearly $1.5 billion in year-end revenue for 2021, but also reported $588 million in losses on the year.