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

UVM Health Network cites administrative issues, seeks to end UnitedHealthcare contract

University of Vermont Medicine Health Network (Burlington) has expressed its intent to end its contract with UnitedHealthcare over administrative and operational hurdles, according to CBS affiliate WCAX.

NYC cannot penalize city retirees for declining contested Emblem Health, Anthem health plan: judge

A New York judge ruled that New York City cannot penalize retirees who decline to participate in a controversial new retiree Medicare Advantage plan provided by Emblem Health and Anthem subsidiary Empire Blue Cross Blue Shield, according to the New…

NAACOS forms coalition to help providers pivot to new CMS ACO model

The National Association of Accountable Care Organizations is forming a new coalition to educate providers on CMS' new ACO REACH model.

5 recent legal actions involving payers

From accusations that Clover Health misled investors to UnitedHealthcare dodging an attempt to reveal negotiated rates with contracted providers, here are five recent legal actions involving payers:

Congress pitches bill to warn Medicare beneficiaries of late enrollment fees

A bill introduced in Congress would require the government to warn adults 60 and older of penalties associated with late Medicare enrollment, according to a March 2 CNBC report.

Clover Health must face lawsuit alleging it misled investors

A judge denied a motion to dismiss a lawsuit out of Nashville, Tenn., that accused Clover Health of misleading investors, according to a Feb. 28 court order.

The Challenges of Building a Successful Provider Network

Building a provider network is challenging. Government regulations are changing, competitors are fast moving, and info sources are scattered. Further, the right network is defined differently by each organization depending on goals and initiatives, member population and more.

Humana co-founder memorialized by statue from noted Louisville sculptor

David Jones, Humana's cofounder, is being memorialized in the company's home city of Louisville, Ky., by a statue created by locally admired artist Ed Hamilton, according to ABC affiliate WHAS11.

Telehealth will enhance, not replace traditional employer plans, Cigna study says

The future of telehealth isn't that it will replace traditional employer plans, but rather pivot them to a hybrid model that emphasizes affordability and accessibility, according to a March report from Cigna subsidiary Evernorth.

Optum information security chief named to national cybersecurity board

Allison Miller, Optum's chief information security officer, was named to the board of directors for nonprofit CISO advocacy group the National Technology Security Coalition as a representative of the healthcare industry, according to a March 2 announcement.