Staff, Author at Becker's Payer Issues | Payer News

Florida says software glitches backed up tens of thousands of children's health claims

Software glitches from Sunshine Health resulted in tens of thousands of disadvantaged children's healthcare claims being delayed for about three months, according to the Tampa Bay Times.

CMS broadens Medicaid lung cancer screenings coverage

CMS updated Medicaid's coverage of an early-detection lung cancer screening Feb. 10, a move that would expand coverage nationwide.

Excellus BCBS pays $30M to 31 New York providers for quality improvements

Excellus BlueCross BlueShield is distributing $30 million across 31 New York providers to invest in quality improvements, according to a news release shared with Becker's.

'Big 6' payers ranked by medical benefits ratio

Payers' medical benefits ratios — the percentage of premium revenue spent on medical services — have fluctuated with the flow of the COVID-19 pandemic, resulting in industrywide increases.

Centene subsidiary renews Louisiana Medicaid administrator contract

The Louisiana Department of Health renewed its contract with Louisiana Healthcare Connections, a Centene subsidiary, on Feb. 14.

FTC to vote on pharmacy benefit manager competition probe

The Federal Trade Commission will vote Feb. 17 whether to investigate the anticompetitive impacts of pharmacy benefit managers on independent pharmacies.

Medicare Advantage is a hot market: Here's how 6 payers rank

Payers have been calling the Medicare Advantage market a competitive, but highly-desirable one.

AHIP calls CMS Alzhimer's drug guidance 'the right approach'

America's Health Insurance Plans supported CMS' preliminary guidance on covering Aduhelm, Biogen's Alzheimer's disease treatment, calling its decision "the right approach."

Payers lag behind wave of mothers pushing for home births

Mothers have increasingly opted to give birth in their homes during the COVID-19 pandemic, but insurers are largely refusing to cover them, according to a Feb. 11 report from Time.

Lawsuit claims Aetna infertility policies discriminate against homosexual women

A lawsuit filed Feb. 9 in Connecticut accuses Aetna of discriminating against homosexual women through its fertility treatment coverage policies, according to Top Class Actions.