Payer Issues Newsletter

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Archived Becker's Payer Issues Report E-Newsletters

October 11, 2024

• • Medicare Advantage star ratings dip | 14-hospital system splits with UnitedHealth | 7 5-star MA plans | FTC's new merger rules: 9 things to know | Hospitals sick of MA fights

October 10, 2024

• • Payers' Milton response: 5 notes | How 2 MA plans got 5 stars from NCQA | CBO: Weight-loss drug coverage could cost Medicare $35B | NY system sues payer | 25 best places to retire

October 09, 2024

• • Duke CEO, UnitedHealth at odds over contract | Harris pitches Medicare home care coverage | 5 payer M&A updates | L.A. Care reaches $55M settlement with Calif. | UHG, CVS want FTC chair off case

October 08, 2024

• • CVS laying off 400+ Aetna employees | Why 1 CEO is worried about PE in Medicaid | Meet UnitedHealth's exec team | 10 payers exiting MA markets | Fla. hospitals brace for 2nd hurricane

October 07, 2024

• • CMS pitches new ACA rules: 10 notes | Texas Medicaid awards halted | Elevance, Centene close sales | 22 states where MA plans are shrinking | 10 UnitedHealth updates

October 04, 2024

• • 16 payer headwinds to know | Senator promises MA investigation | UnitedHealth expanding ACA plans | Kan. rejects Aetna's Medicaid challenge | CMS tweaks drug negotiations for '25

October 03, 2024

• • United sues CMS over star ratings | MA 'jeopardizing' rural hospitals | CVS breakup may be hard to do: 3 notes | Blue Shield Calif.'s $0 biosimilar plan: 7 notes | Elevance plans $11.9M expansion

October 02, 2024

• • Another MA exit | Humana's star ratings tumble | Inside Cigna's new GLP-1 program | Calif. enacts AI-driven coverage decisions law | Vance, Walz debate: 4 notes

October 01, 2024

• • New MA plans for '25 | UnitedHealth launches gold card program | Calif. fines Anthem $8.5M | Best-rated MA plans in '24 | CVS board mulls break up

September 30, 2024

• • CMS: MA, Part D stable in '25 | Sentara cuts insurance jobs | Investors sour on CVS | Calif. mandates IVF coverage | 7 Helene updates

September 27, 2024

• • Another system scales back MA | Payer with best virtual care: JD Power | A 'ripe opportunity' for provider-led plans | CMS' new Medicaid guidance: 7 notes | GLP-1 pills on the horizon

September 26, 2024

• • Dems pitch permanent ACA subsidies | OIG audits Humana, Aetna for MA overpayments: 10 things to know | Mark Cuban's message to employers | Md. reverses on Kaiser Medicaid: 5 notes | 5 Ozempic updates

September 25, 2024

• • BCBS La. hit with $421M fraud verdict | Lowest-rated health plans of '24 | Harris' drug spending cap plan: 4 notes | CMS finalizes ACO catheter rule | 8 payers exiting MA markets

September 24, 2024

• • How a 5-star MA plan views growth | Inside the GLP-1 'price war' | UnitedHeath to provide mental healthcare to 1M children | Epic faces antitrust lawsuit | States with largest Medicaid declines

September 23, 2024

• • Md. to drop Kaiser Medicaid | UPMC Health Plan's top GLP-1 challenge | FTC v. PBMs: 10 notes | Best commercial plans by state | How CareFirst guides AI startups

September 20, 2024

• • Another round of Optum layoffs | Cigna to trim MA plans | Best Medicaid plans in '24 | Aetna, HCA Fla. reach deal | 3 GLP-1 updates

September 19, 2024

• • Texas system ends MA plan | Trump to change ACA risk pools, Vance says | Oak Street settles MA kickback allegations | States ranked by average ACA subsidy | Top Medicaid plan in each state

September 18, 2024

• • Why Humana is moving into Walmart | Best MA plans in each state | 4 best payers for hybrid work | Fla. Blue, Baptist facing split | Hospitals confront Change hack fallout

September 17, 2024

• • Cigna sues FTC | Healthcare fades from election agenda | Some MA plans shrug off headwinds | Wegovy beats out rival drug | UnitedHealth's 10 public policy recs

September 16, 2024

• • Best health plans: NCQA | MA plans grapple with election noise | HCSC-Cigna Medicare deal approved in Fla. | Centene settles NY Medicaid issue for $7.6M | The next big ACA fight

September 13, 2024

• • Elevance escalates Ozempic crackdown | Payers ranked by MA star bonuses | Medicaid pressures to hit Centene Q3 earnings | Should the MA window be widened? | 7 best payers to work for: Fortune

September 12, 2024

• • MA bonuses decline | Mercy hands Anthem contract ultimatum | CMS suspends enrollment for Centene plan | AI linked to claims denial surge: AHA | 6 prior auth updates

September 11, 2024

• • Elevance to buy IU Health Plans | Trump, Harris debate: 3 healthcare takeaways | GLP-1 coverage: 10 key numbers | Optum drops Humira | Payers ranked by digital offerings

September 10, 2024

• • Great disruption' looms for MA | Aetna, 48 HCA Fla. hospitals face split | PBMs by market share | 9 payers recently fined | 7 Medicaid contract updates

September 09, 2024

• • Biden expands mental health parity law | Cigna CEO: Expect GLP-1 'choppiness' | No future sale for BCBS La., CEO says | 20 payers raising ACA premiums | The MA plan not sweating inpatient pressures

September 06, 2024

• • 50 payers lowering ACA premiums | Top-rated payers' MA strategies | Centene: GLP-1s a Medicaid pressure | PE firm merges 3 payment cos. | 10 UnitedHealth updates

September 05, 2024

• • Humana preps for MA 'frustration' | Payers ditch deductibles | Elevance entering new ACA markets | Most promising insurtechs in '24 | Molina expands CFO role

September 04, 2024

• • An MA lesson from the '90s | UnitedHealth, U of Florida Health split | HCSC launching 'alternative' health plan | The impact of GLP-1s on COVID | City of Hope hires Optum exec

September 03, 2024

• • Inside UnitedHealth's gold card program | Best insurance brands in '24 | Aetna, Providence split | Ind. launches payer pricing site | 10 best, worst cities to retire

August 30, 2024

• • Trump floats IVF coverage mandate | Miss. awards Medicaid contracts | Blue Shield Calif. fined over birth control copays | UnitedHealth: 9 maternal health trends | 15 recent payer exec moves

August 29, 2024

• • 7 most dangerous trends facing payers | 10 M&A updates | Lawmaker: PBM execs made false statements | What happens when MA contracts are terminated? | 6 GLP-1 updates

August 28, 2024

• • Centene to end Part D broker payments | Inside a system's split with UnitedHealth | Cigna to remove Humira from most formularies | Direct contracting grows: 6 notes | 7 payers fined by states

August 27, 2024

• • CMS dropped MA rule after payer pushback: Report | Aetna's 'landmark' fertility decision | Elevance drops Evolent interest | CareFirst, Johns Hopkins launch AI initiative | Counties with narrowest ACA networks

August 26, 2024

• • UnitedHealth eyes 3rd largest ASC chain | Calif. network directory reform bill dead | MA plan: Headwinds have 'minimal impact' | States ranked by Medicaid spending | 10 states reforming prior auth

August 23, 2024

• • Elevance eyes Evolent | BCBS Minn. to face DOL suit | Most common No Surprises complaints | How Congress gets health coverage | 12 Envision notes

August 22, 2024

• • Lowest-rated MA plans in '24 | Employers' top GLP-1 concerns | Lawmakers zero in on MultiPlan | UnitedHealth adds prior auth rules | Molina extends CEO contract

August 21, 2024

• • Top payer employer in each state | Layoffs at BCBS Mich. | Nev. system ends UnitedHealth contract | What's behind great star ratings: McKinsey | Judge blocks noncompete ban

August 20, 2024

• • Top MA plans in '24 | Allina's Optum deal pays off | Calif. prior auth bill advances | 3 payer trends hospitals need to know | A landmark year for CEO turnover

August 19, 2024

• • Humana settles Medicare fraud case for $90M | Inside Optum's success | Harris + Medicare for All: 5 notes | Judge tosses hospital suit against MultiPlan | Counties with highest MA rates

August 16, 2024

• • MA woes loom for hospitals | 50 notes on payer CEOs | Calif. fines Anthem over gender-affirming care | Ga. to use state-run exchange | 10 billing fraud cases

August 15, 2024

• • 6 CEO takes on MA landscape | 2-midnight rule has mixed results for hospitals | UnitedHealth, Colo. system facing split | A looming 'perfect storm' for Medicare enrollment | CMS’ 10 negotiated drug prices

August 14, 2024

• • A looming MA 'lobbying blitz' | Elevance launches new primary care business | States ranked by GLP-1 coverage rates | 7 payers cutting prior auth | 11 UnitedHealth updates

August 13, 2024

• • The politics of ACA ambiguity | MA penetration by state | Payers ranked by Q2 MLRs | How BCBS Mich. became a tech leader | Why Kaiser has Target clinics

August 12, 2024

• • UnitedHealth embraces consumerism | Payers ranked by Q2 profits | Medicare telehealth in limbo | MA plans with worst prior auth denial rates | Best, worst states to live in

August 09, 2024

• • Is the 2-midnight rule costing payers? | Hospitals make MA missteps, too: Jain | Payers pledge PBM defense | Overused healthcare buzzwords, per execs | GLP-1s increasing ACA premiums

August 08, 2024

• • CVS issues MA warning | Fla. Blue parent closing clinics | States that cover GLP-1s for employees | Calif. payer reduces prior auth | Elevance's global CIO departs

August 07, 2024

• • Aetna president out | Centene exiting 6 MA markets | BCBS SC selling care group to Novant | Clover turns 1st profit | BCBS La. rebrands

August 06, 2024

• • UnitedHealth sues Minn. over Medicaid law | VP pick Walz on healthcare: 8 notes | Uninsured rates creep up | 7 payers on Fortune's Global 500 | Humana CEO: MA plans can work better with CMS

August 05, 2024

• • This is dire': Texas systems could lose health plans | WSJ: Insurers made $15B off home visits | DOJ offers rewards to healthcare whistleblowers | 12 execs who have left Optum | 2 million enroll in Cigna's GLP-1 program

August 02, 2024

• • Humana: 2-midnight rule raising costs | Cuban's big warning for employers | ICHRA a 'niche' market: Cigna | CMS finalizes 4 payment rules | 12 recent payer CEO moves

August 01, 2024

• • Cigna posts $1.5B Q2 profit | UnitedHealth launching gold card program | Humana expects decline in MA members | Wells Fargo sued over drug costs | 22 payer exec moves in July

July 31, 2024

• • Change breach notifications begin | Humana posts $679M Q2 profit | MultiPlan fights insurer collusion allegations | A new primary care strategy at Anthem Calif. | 5 MA study findings

July 30, 2024

• • 7 MA market exits | Centene names Medicaid CEO | How 8 payers are solving workforce issues | 7 GLP-1 updates | Envision exits Calif.

July 29, 2024

• • UnitedHealth revamps provider search | Centene to exit MA markets | BCBS Vt. in 'fragile' state | Molina's 'very active' M&A pipeline | 10 best, worst states for healthcare

July 26, 2024

• • Why Optum backed out of Steward deal | Centene posts $1.1B Q2 profit | Humana partners with Google | CEO of fake Fla. payer sentenced to prison | Best payer employers for women

July 25, 2024

• • Optum closing clinics, cutting 500+ jobs | Humana CEO backs MA prior auth bill | Centene selling Fla. subsidiary | Payers owe $10.3B in risk adjustments | 42 healthcare leaders under 40

July 24, 2024

• • Humana moves on Walmart clinics | 39 healthcare providers sue UnitedHealth | Molina to buy ConnectiCare | MA accounts for rising share of inpatient days | Cigna launches $9M health equity fund

July 23, 2024

• • 15 hospitals dropping MA plans | NC adds Medicaid weight loss drug coverage | 7 best payers for LGBTQ employees | Can Gen Z define deductible, copay? | The price of being a workaholic

July 22, 2024

• • Why 4 physicians became payer CEOs | Insurers with best employee pay growth | Harris' healthcare policy positions | Humana backs AI-powered MA platform | 12 UnitedHealth updates

July 19, 2024

• • More Optum layoffs | Fla. awards more Medicaid contracts | 20 top payers for disability inclusion | AI a cost-saver for UnitedHealth, CEO says | 8 recent payer lawsuits

July 18, 2024

• • UnitedHealth was 'over-optimistic' about Change recovery: CEO | Top payer employers, per Gen Z | House summons payer execs for PBM hearing | Elevance: Medicaid utilization is rising | BCBS La. restructures

July 17, 2024

• • Elevance posts $2.3B Q2 profit | UnitedHealth CEO defends MA home visits | Top Humana exec departs | RI awards Medicaid contracts | JD Vance's healthcare record: 6 notes

July 16, 2024

• • UnitedHealth posts $4.2B Q2 profit | Why prior auth could become an AI 'arms race' | 11 arrested at UnitedHealth protest | Change breach costs soar | 10 MA updates

July 15, 2024

• • Centene beats Medicaid fraud suit | Elevance plans primary care partnership | BCBS and MA: 7 updates | Highmark loses 26K-member contract | 8 updates on GLP-1s

July 12, 2024

• • Aetna cited in 1st No Surprises audit | MA the lynchpin in hospital-payer disputes | 14 top plans on what members want | Optum taps clinical data exec | Payers to face FTC lawsuit over PBMs

July 11, 2024

• • Payers face COVID vaccine lawsuits | Sanford, Security Health Plans eye merger | Insurers back 'old-fashioned' weight loss method | CMS floats 2 payment rules | Top issues for payer CFOs

July 10, 2024

• • UnitedHealth sued over DOJ probe | FTC slams PBMs | The 'critical success factor' behind MA at BCBS Mich. | Change preps breach notifications | SCAN taps 5 new execs

July 09, 2024

• • Insurers gain $50B from 'questionable' MA coding | Aetna snags win in NC contract fight | 5 recently fined payers | Highmark names market leaders | New study: Ozempic vs. Mounjaro

July 08, 2024

• • Learning in one click — See the latest opportunity from Becker's

July 05, 2024

• • The GLP-1 coverage dilemma | 15 payers cutting jobs | How a BCBS CEO approached year 1 on the job | Texas fines Cigna over claims disputes | 10 UnitedHealth updates

July 03, 2024

• • More MA plans snag 5 stars | The payer eyeing Walmart's clinics | Layoffs at AmeriHealth Caritas | Ore. expands Medicaid | Biden to Ozempic maker: 'Stop ripping off' Americans

July 02, 2024

• • Ex-BCBS worker wins COVID vaccine case | UnitedHealth, Trinity split in 6 states | Top insurers for customer experience: Forrester | Kaiser lays off 51 | 10 key MA updates in '24

July 01, 2024

• • UnitedHealth, Amedisys reach divestiture deal | Humana's new CEO takes over | What Chevron ruling means for healthcare | Optum agrees to $20M opioid settlement | BCBS plan reduces prior auth

June 28, 2024

• • Optum scraps Steward deal | 5 highest-paying states for health execs | 17 payers' top priorities | NY system drops Humana MA | Ascension to pull Texas plans

June 27, 2024

• • How a NY payer avoids MA hospital tensions | Lawmakers to consider GLP-1 Medicare coverage | Del. drops MA for retirees | Startup payer raises $165M | 10 key UnitedHealth updates

June 26, 2024

• • MA plans need tougher AI rules: Lawmakers | BCBS and GLP-1s: 5 updates | Best payers to work for: US News | Hospital limits hiring after Change hack | The policies states still want after Medicaid unwinding

June 25, 2024

• • SCOTUS rejects $2.7B BCBS settlement challenge | Optum's Calif. president departs | Teva launches first generic GLP-1 | Inside Blue Shield Calif.'s new state contract | 8 MA updates

June 24, 2024

• • Blue Shield Calif. fires top exec | Court upholds ACA preventive care mandate | Fitch: Medicaid headwinds likely short-term | Risant to acquire Cone Health, MA plan | 10 recent billing fraud cases

June 21, 2024

• • Change issues data breach notices | NY fines UnitedHealth $1M | Texas payer warns of closure | Cigna names chief finance exec | US uninsured rate to rise: CBO

June 20, 2024

• • Priority Health to buy Ind. payer | 7 state contract shakeups | 3 Qs for the future of the individual market | Texas physician convicted in $70M fraud scheme | 40 things to know about CVS Health

June 19, 2024

• • Most valuable payer brands | Insured patients often save less with Cost Plus: Study | Sanders calls out payers' contraception coverage | Amazon expands RxPass to Medicare | Uninsured pop. drops to 25 million

June 18, 2024

• • MA headwinds hit BCBS | UnitedHealth trade secrets lawsuit dismissed | Ascension's ACA plans disrupted by hack | CMS to end Change hack support | Former Aetna CEO dies at 93

June 17, 2024

• • Elevance bucks MA headwinds | CMS extends No Surprises disputes amid Change hack | Aetna, Hackensack facing July 1 split | The delicate dance between employers and claims data | 10 UnitedHealth updates

June 14, 2024

• • CMS recalculates MA star ratings | More employers opt for weight loss drugs | Payers, providers back new MA prior auth bill | CMS closes HQ after Legionella found | 5 recent payer exec moves

June 13, 2024

• • Lawmakers: UnitedHealth is violating HIPAA | Cigna: Weight loss drugs 'hottest topic' | Healthcare bill targets 'corporate greed' | This CEO wants a Medicare reboot | Cost Plus teams with 2,000 grocery stores

June 12, 2024

• • Lawmakers: UnitedHealth is violating HIPAA | Cigna: Weight loss drugs 'hottest topic' | Healthcare bill targets 'corporate greed' | This CEO wants a Medicare reboot | Cost Plus teams with 2,000 grocery stores

June 11, 2024

• • Elevance gets partial win in star ratings challenge | Texas rejects Medicaid protests | MA members spend $2,500 less than FFS beneficiaries | Why CDPHP, Excellus want to combine | 160 CFOs to know

June 10, 2024

• • Humana's MA audits lawsuit moves forward | Change can't keep hack suits in Tenn. | Baylor Scott & White, BCBS face July split | Optum sells settlement solutions business | Oscar eyes doubled membership

June 7, 2024

• • 32 payer execs discuss healthcare's future | Top AI opportunities for insurers | 10 providers seeking payer contracting talent | 17 healthcare cos. lauded for leadership | 5 recent housing investments

June 6, 2024

• • Ex-Cigna exec still barred from CVS role | UnitedHealth, Ala. system split | Payers estimate $1.1B in '24 MLR rebates | Data grows on GLP-1s, surgical issues | Aetna taps head of commercial regions

June 5, 2024

• • SCAN beats CMS in MA stars suit | A 'rough year' for gov't programs | UnitedHealth testing 500 AI use cases | US 'hits a wall' reducing burnout | Top-paid CEOs in '23

June 4, 2024

• • Pharma exec charged with threatening Aetna leaders | UnitedHealth-Amedisys divestiture stalls | Weight loss drug coverage gets more complex | Unhealthiest states for seniors in '24 | 10 recent billing fraud cases

June 3, 2024

• • Change responsible for breach reporting: HHS | Layoffs at Cigna | BCBS plan exiting MA | 3 states tackling prior auth | How Optum cut behavioral wait times

May 31, 2024

• • Change hack a result of 'corporate negligence': Senator | Payer-provider negotiations 'coming to a head' | DOJ rejects Steward's Optum sale timeline | Inside a health plan's hybrid work strategy | 8 exec moves in May

May 30, 2024

• • A 'disturbance' in Medicaid margins | Lowest-ranked health plans of '24 | Health system rehires Humana exec as CEO | Senators demand answers from MultiPlan | 7 GLP-1 updates

May 29, 2024

• • Top health plans of '24 | Epic exec: AI far from fixing prior auth | Minn. Medicaid to drop for-profit carriers | Op-ed: Elevance's global CIO | Should healthcare execs take the Hippocratic Oath?

May 28, 2024

• • Why 2 payer CEOs embrace MA cuts | Third round of Highmark layoffs | Ill. passes prior auth reform | Novo Nordisk defends Ozempic price | NYC continues Aetna MA push

May 24, 2024

• • UnitedHealth buys Minn. behavioral clinics | Prior auth inpatient claim denial rates by payer type | CVS seeks Oak Street PE backer | 10 BCBS updates | Aetna challenging Kan. Medicaid awards

May 23, 2024

• • UnitedHealth wants MA algorithm suit tossed | NY payers pitch merger | Blue Shield Calif. taps chief actuary | States ranked by ACA growth | US News adds MA data to rankings

May 22, 2024

• • 7 providers being bought by payers | Best payer employers for new grads: Fortune | Okla. tackles prior auth reform | Health systems' hard line on insurers pays off | 7 MA updates

May 21, 2024

• • UnitedHealth failed to disclose antitrust probe: Lawsuit | ACA gains favor | BCBSA: Most GLP-1 users quit before seeing benefits | Vt. enacts prior auth reforms | Optum Rx rolls out new pricing model

May 20, 2024

• • Optum layoffs in Ohio | 10 key questions facing MA | ICHRA growth up nearly 30% | Blue Shield Calif. names president | 17 quick notes on healthcare

May 17, 2024

• • UnitedHealth beats TeamHealth suit | Neb. system drops MA | GLP-1s poised to bankrupt Medicare, Sanders warns | Optum-Steward deal moves forward | HCSC plans Texas office

May 16, 2024

• • UnitedHealth 'really comfortable' with MA | BCBS Mich. names new CEO | 8 two-midnights updates | 10 top states for commercial rates | CommonSpirit's 'firm stance' on payers

May 15, 2024

• • CVS could lose 10% of MA members | Layoffs at Texas Children's Health Plan | Minn. fines UnitedHealth over mental health parity | Kan. awards Medicaid contracts | Wegovy's longest trial yet: 2 findings

May 14, 2024

• • Optum spends $31B on M&A | Humana's new CEO starts in July | Payers spend 254% of Medicare rates: Study | 2-midnight rule may affect 20% of MA patients | Site-neutral payment policies: 20 notes

May 13, 2024

• • CMS extends Medicaid waivers | MultiPlan not changing strategy, CEO says | Inside an MA startup's grassroots approach | Kaiser posts $935M Q1 operating profit | 10 best cities to start a career

May 10, 2024

• • UnitedHealth, Amedisys to sell 100 clinics | 'Ongoing cartel': CHS sues MultiPlan | DOJ forms antitrust task force | What healthcare learned from Change hack | IRS posts HSA, HDHP limits for '25

May 9, 2024

• • Cigna + Oscar to end | Utah fines UnitedHealth | CVS mental health leader departs | Limiting MA patient surveys could save billions | 8 things to know about GLP-1s

May 8, 2024

• • More Highmark layoffs | Optum's bank: 10 things to know | BCBS La. taps new CEO | Lawmakers want new UnitedHealth probe | Payers ranked by D-SNP members

May 7, 2024

• • Kaiser, Molina cut jobs | Oscar reports 1st profit | 5 MA updates | Aetna settles LGBTQ+ fertility lawsuit | 10 best states for healthcare

May 6, 2024

• • MA extras on the chopping block | Payers ranked by Q1 medical loss ratios | Steward files for bankruptcy | Senator calls for MultiPlan probe | Optum seeks clawbacks from social workers

May 3, 2024

• • Payers' Q1 revenue, profit | 9 payer M&A updates | Cigna: More employers covering weight loss drugs | DACA recipients eligible for ACA coverage | Premera taps chief medical officer

May 2, 2024

• • Crisis of your creating': UnitedHealth CEO rebuked by lawmakers | Cigna posts $277M Q1 loss | CVS' new MA strategy | CommonSpirit, Anthem split | Another system partners with Cost Plus

May 1, 2024

• • UnitedHealth, Walmart MA plan discontinued | CVS cuts earnings guidance on rising MA costs | Who OK'd decision to pay Change ransom | MultiPlan faces another lawsuit | 10 payer exec moves in April

April 30, 2024

• • Walmart Health shutters | HEDIS reporting delayed | Molina eyes M&A | CVS, Cigna lean into biosimilars | Health system, payer CEO salaries ranked

April 29, 2024

• • Calif. eyes single-payer again | States ranked by Ozempic demand | 6 execs that have left Optum | How the payer workforce will evolve | 12 UnitedHealth updates

April 26, 2024

• • Kaiser alerts 13M members of data breach | Centene posts $1.2B Q1 profit | State AGs decry Change's hack response | Payers ranked by CEO-to-worker pay | Weight loss drugs help drive 13.5% increase in pharma costs

April 25, 2024

• • Optum Virtual Care shutting down | Humana to exit MA markets | Payers ranked by CEO-to-worker pay | UPMC lays off nearly 1,000 | 25 best payers for diversity

April 24, 2024

• • Highest-paid payer CEOs | UnitedHealth pays hackers | Humana posts $741M Q1 profit | Calif. hospitals sue Anthem | 5 MA updates

April 23, 2024

• • UnitedHealth's top-earning execs | Analysts not ruling out Cigna-Humana deal | CMS finalizes Medicaid managed care rule | Feds to probe integrated Part D-PBMs | Cardinal, OptumRx split

April 22, 2024

• • Optum enacts layoffs | Elevance awarded $400M behavioral contract | 80% of Change systems restored | Calif. hospital to lose Medicare contract | 2 payers among LinkedIn's best workplaces

April 19, 2024

• • Elevance details new $4B primary care arm | Texas shakes up Medicaid contracts | Court revives UnitedHealth mental health parity suit | Feds launch antitrust reporting portal | The rise of 'social prescribing'

April 18, 2024

• • Elevance posts $2.2B Q1 profit | UnitedHealth owning Change helps US, says CEO | Pa. systems sue Aetna | Best healthcare cos. for career growth | Miss. weighs state-based exchange

April 17, 2024

• • Lawmakers blast UnitedHealth | Man charged in $70M Medicare fraud scheme | Inside Blue Shield of Calif.'s virtual plan | UnitedHealth: MA costs stabilizing | 100 top hospitals: Fortune

April 16, 2024

• • UnitedHealth posts $1.4B Q1 loss | 5 positive signs of prior auth reform | Elevance, PE firm strike primary care deal | CMS delays new data rules | Envision taps CEO

April 15, 2024

• • Feds probe Sentara's health plan | Fla. to award 5 Medicaid contracts | AHIP takes aim at hospital lobby's Change response | BCBS plan reports $26M operating loss | 12 recent billing fraud cases

April 12, 2024

• • 100 things to know about BCBS | CMS pitches 2025 inpatient payment rule | Elevance to acquire N.Y. Medicaid plan | Meet UnitedHealth's executive team | Why CEO pay is on the rise

April 11, 2024

• • UHG officials sold stock before probe became public | Former Centene exec named VillageMD president | Payer awards hospital grant to stave off closure | Michigan awards Medicaid contracts | Best, worst states for remote work

April 10, 2024

• • 2nd group tries extorting Change | CVS Health's 5 highest-paid execs | Major insurers made millions using MultiPlan | Becerra mulls HHS exit | A possible Ozempic baby boom

April 9, 2024

• • Hospitals' MA issue hits inflection point | Payer outlook clouded by rising Medicare use | 5 M&A updates | BCBS Mass. raising primary care rates | 150 top places to work in healthcare

April 8, 2024

• • Hackers claim to get CVS, CMS data in Change hack | Aetna, Dignity cut ties | 3 Optum M&A updates | 2 Neb. hospitals abruptly close | 10 MA updates

April 5, 2024

• • CMS posts MA final rule | UnitedHealth shifts execs | Mark Cuban, CVS exec joust | Why one payer CEO feels good about MA rates | Walmart Health expands in Texas

April 4, 2024

• • UnitedHealth, Aetna name Medicare leaders | Where MA utilization is rising most | Aetna, Horizon snag NJ state contracts | Point32Health to make prior auth cuts | 8 best healthcare companies to work for

April 3, 2024

• • Why MA rates don't mirror rising costs | Risant buys Geisinger | CMS finalizes ACA network rules | BCBS to face Ford antitrust claims | 35 billionaires in US healthcare

April 2, 2024

• • CMS posts MA rates | Elevance's 5 highest-earners | Home Depot wants $2.7B BCBS settlement blocked | 1 year of Medicaid redeterminations | 5 things to know about UnitedHealth's new president

April 1, 2024

• • Lawmakers set hearing with UnitedHealth CEO | Trump: 'I'm not running to terminate the ACA' | Centene's 5 highest-earners | 6 most innovative insurers: Fortune | 10 recent payer exec moves

March 29, 2024

• • UnitedHealth names president | Elevance, Kaiser, CVS to cover Wegovy | 32 docs leave Optum-owned group | The $5 Ozempic debate | Q&A with Aetna's chief medical officer

March 28, 2024

• • Feds offer $10M for intel on Change hack | Biden takes aim at junk plans | Payers' membership mix | Why Blue Shield of Calif. partners with Big Tech | MA plan facing termination challenges CMS

March 27, 2024

• • Optum to buy Steward physician group | Medicare weight loss drug spending skyrockets | Overturned claims denials by payer type | 6 payers among top-rated workplaces | 5 BCBS updates

March 26, 2024

• • Top investment 21 payer execs are making | Lawmaker: Lack of UnitedHealth transparency 'handcuffed' Change response | Humana wants MA AI lawsuit tossed | Biden leans into the ACA | Molina's 5 highest-paid execs

March 25, 2024

• • Change to start processing claims | 45% of systems mull MA breakups | Lawmakers seek hearing with UnitedHealth CEO | Ex-Ga. insurance comm. pleads guilty to fraud | 10 new payer partnerships

March 22, 2024

• • Last-ditch email to UnitedHealth's CEO saves clinic | Medicare will cover Wegovy | 10 greatest payers for job starters | GOP lawmakers: MA rates 'baffling' | Provider lawsuits pile up following Change hack

March 21, 2024

• • UnitedHealth-Amedisys deal faces more scrutiny | How CMS is digitizing prior auth | HHS tightens tracking tool rules | The '3rd generation' of weight loss drugs | 9 MA updates

March 20, 2024

• • Top 10 insurers in '24 | Elevance goes on acquisition spree | UnitedHealth, Sinai end dispute | CMS adds new ACO model | A Change cyberattack timeline

March 19, 2024

• • Change attack: What 15 payers discussed in DC | Elevance to buy Kroger specialty pharmacy | The succession strategy for a 20-year CEO | 5 trends shaping MA's future | 32 health plans awarded USPS contract

March 18, 2024

• • UnitedHealth launches claims solution + payers head to DC | Hospital CEO blames MA for layoffs | Cigna's 5 highest-paid execs | MedPAC: MA needs major overhaul | Walgreens lays off 600+

March 15, 2024

• • Optum gets green light on Ore. clinic purchase | One Medical patients affected by UnitedHealth, Mount Sinai dispute | 5 prior auth updates | 9 Medicaid programs that cover Wegovy | 15 best payer workplaces for women

March 14, 2024

• • HHS opens UnitedHealth investigation | AHIP, HHS diverge on relaxing prior auth | A 'paradigm shift' in weight loss drug coverage | States that could see more MA dollars in '25 | Optum names division CEO

March 13, 2024

• • Andrew Witty called to White House | Optum wants quicker Ore. clinic purchase | What Humana execs could make from M&A deal | Eli Lilly taps Amazon to ship weight loss drugs | 9 payer M&A updates

March 12, 2024

• • More Highmark layoffs | Biden pitches Medicaid, ACA policies | Health systems' MA plight | How Change hack could change healthcare | Part D plans ramp up prior auth

March 11, 2024

• • Feds urge Change hack aid from payers | Fastest growing MA startups | Elevance closes on Paragon deal | 6 health systems limiting weight loss drug coverage | What Mark Cuban learned from a $141K oversight

March 08, 2024

• • UnitedHealth offers recovery timeline | Kaiser conducts 2nd IT layoff | 3 Blues plan reporting losses in '23 | Inside Cigna's new weight loss program | State of the Union: 13 healthcare updates

March 07, 2024

• • Lawsuits, payer disruptions follow Change hack | Cuban inks 1st health system partnership | The 26 states where MA is the majority | Va. awards Medicaid contracts | 8 Ozempic updates

March 06, 2024

• • Change Healthcare hackers get $22M payment | Former Walgreens legal chief joins UnitedHealth | Feds spotlight healthcare deals | Centene's canceled HQ attracts suitors | 4 hospital closures

March 05, 2024

• • Elevance gets MA star ratings boost | 4 payers among world's 'most ethical' companies | What Change hack is costing systems | Excellus posts first loss in 15 years | CommonSpirit 'having real issues' with MA

March 04, 2024

• • Andrew Witty on the UHC-Optum relationship | Aetna reports disruptions from Change hack + 7 updates | Appellate court to hear ACA case | 7 healthcare trends to watch | CVS settles understaffing cases

March 01, 2024

• • 50 things to know about UnitedHealth Group | Change hack hits physician practices hard | Ozempic's potential rival | 10 MA updates | Highmark launches new business segment

February 29, 2024

• • 7 payers cutting jobs | Hackers claim massive data haul in Change attack | Humana's highest-earning execs | Are 8 a.m. meetings back? | 10 states that could see largest MA cuts in '25

February 28, 2024

• • UnitedHeath faces antitrust probe | AHA: Change attack will hurt hospital finances, credit neutral for UnitedHealth | CareSource to acquire ACA co-op | Hospital CFOs 'cautiously optimistic' on 2-midnight rule | 3 recent MA studies

February 27, 2024

• • Ransomware gang behind Change attack: Report | MA members could see $396 cut in '25 | Elevance to launch weight management program | The best changes made this year | Walmart prefers these hospitals for workers

 February 26, 2024

• • Anthem 'massively screwed up' MA contract: NH official | Change Healthcare hack fallout continues | 5 payer execs among the most influential CEOs | What Ozempic and layoffs have in common | Single payer still a tough sell

February 23, 2024

• • 'Nation-state' suspected in Change outage | CMS wants staff back in office | MA members report more care delays | 7 payer M&A updates | Will health insurance have a climate change problem?

February 22, 2024

• • Berwick: Hospital-MA fights signal 'broken system' | Optum's Change Healthcare hit by cyberattack | Ill. vows to ban behavioral prior auth | Ind. system drops Aetna, Humana MA | Who is winning surprise billing disputes?

February 21, 2024

• • Inside Aetna's major MA growth | Tide turns on healthcare megadeals | 5 BCBS updates | Why 4 systems outsourced to Optum | Friday Health collapse spurs Colo. legislation

February 20, 2024

• • The changing insurance workplace | Employers' waning hesitancy on weight loss drugs | 3 ended Optum contracts | 350 payer execs on top industry challenges | Americans overdo 'alone time'

February 19, 2024

• • Health systems ditch health plans | UnitedHealth names COO | Q&A with CareFirst's CEO | No Surprises disputes 13x higher than estimated | Payers ranked by '23 Medicaid losses

February 16, 2024

• • Another state drops Optum | Mass. system to sell insurance arm | 'Unique implications' of MA for rural hospitals | Cigna to buy back $3.2B in stock | Payers ranked by total members

February 15, 2024

• • MA benefits face the chopping block | Payer M&A derails | 5 prior auth updates | Cuban opens shop for hospitals | 6 Ozempic updates

February 14, 2024

• • 2 insurance mergers called off | 2-midnight rule: Hospitals, payers weigh in | 26 payers among nation's best employers | Humana sued over MA 340B payments | 12 UnitedHealth updates

February 13, 2024

• • Elevance cuts jobs in Mich. | Former CMS admin: 'I would like to see MA slowed or stopped' | BCBS plans ranked by Q3 profit margin | Kaiser membership declines | Cigna partners with HelloFresh

February 12, 2024

• • Best insurers for employee investment | 6 viewpoints on rising MA costs | Payers ranked by revenue, MLRs in '23 | CMS issues AI guidance for MA | 5 Optum updates

February 9, 2024

• • Most profitable payers in '23 | Why Optum, SSM cut ties | Payers sweat proposed MA rates | 3 BCBS plans becoming providers | Health systems shouldn't be insurers: Penn CEO

February 8, 2024

• • Most profitable payers in '23 | Insurers in '2 camps' on rising MA costs | UnitedHealth COO to depart | Calif. payer drops 4 Prime hospitals | HCSC faces uphill Medicare battle

February 7, 2024

• • CVS faces rising MA costs | Amazon cuts healthcare jobs | 5 Ozempic updates | What's behind Fla.'s health insurance crisis? | 9 MA updates

February 6, 2024

• • Centene posts 88% ACA growth | Humana leaving HQ | 1 payer's strategy as hospitals side eye MA | J&J accused of health plan mismanagement | Cano files for bankruptcy

February 5, 2024

• • Medica cuts jobs; employee arrested | Cigna CEO: Medicare still attractive | Dignity, BCBS Ariz. split | Healthcare job growth at 32-yr. high | Optum didn't build hospitals – it hired their staff

February 2, 2024

• • 5 payers cutting jobs | Optum, Allina partner | Cigna posts $1B Q4 profit | Rising MA use could boost hospital margins | La. physicians oppose Elevance-BCBS deal

February 1, 2024

• • CMS pitches MA cuts | Optum shutters behavioral clinics | Cigna's new path for M&A | The most 'overrated' CEOs | 6 most admired payers: Fortune

January 31, 2024

• • Cigna, HCSC ink $3.3B Medicare deal | Walgreens cuts more corporate jobs | States ranked by ACA growth in '24 | 61 senators to CMS: Don't change MA | 30 recent payer exec moves

January 30, 2024

• • Calif. insurers increase office security | Sachin Jain: 5 ways to improve MA | Best payers for workplace diversity | Remote workers laid off more, analysis finds | Lawmakers urge MA overpayment action

January 29, 2024

• • Has MA lost its luster? | A flurry of prior auth reform bills | Medical Mutual to buy Ohio insurer | The hottest new role in corporate America | NC state plan drops weight loss drugs

January 26, 2024

• • CMS wants MA transparency | BCBS NC can challenge Aetna's state contract win | NJ reforms prior auth | HDHP growth stalls | Amazon CEO: Healthcare is 'just kind of nutty'

January 25, 2024

• • Humana posts $541M Q4 loss | Tyson drops CVS Caremark | UnitedHealth launches vendor network | Price transparency company raises $30M | Inside Amazon's healthcare vision

January 24, 2024

• • Elevance posts Q4 earnings, projects flat MA growth | Healthcare CEO pay returns to the Hill | 4 prior auth updates | Optum launches telehealth service | 10 recent billing fraud cases

January 23, 2024

• • Where MA enrollment declined for '24 | 6 Optum updates | BCBS plans cover sickle cell therapy | The fastest-growing C-suite job | 50 top hospitals: Healthgrades

January 22, 2024

• • Payers ranked by MA enrollment in '24 | UnitedHealth's AI strategy: 3 notes | Medicaid disenrollments top 15M | Centene taps Medicare CEO | 21 payer growth strategies for '24

January 19, 2024

• • Inside UnitedHealth's fastest growing health plan | 5 ICHRA updates | What's going wrong with Medicaid unwinding | Ozempic gets pricier | 5 MA study findings

January 18, 2024

• • Labor Dept. sues BCBS Minn. | Humana: Higher medical costs will hurt profits | Court upholds UnitedHealth facility fee win | MedPAC: MA overpayments to reach $88B in '24 | Payers, providers weigh in on new prior auth rule

January 17, 2024

• • CMS finalizes prior auth rule | Humana plans 'limited' layoffs | Cigna shakes up C-suite | What's driving rising MA costs at UnitedHealth | BCBS NC buys urgent care clinics

January 16, 2024

• • Hospitals aren't breaking up with MA: UnitedHealth | World's 10 largest insurers | The MA landscape in '24: 10 notes | Walmart Health seeking leaders | 11 recent payer exec moves

January 12, 2024

• • UnitedHealth posts $5.5B Q4 profit | Envision names board | CMS' prior auth overhaul timeline unclear | Pa. launches claims appeal website | 4 recently terminated MA contracts

January 11, 2024

• • Best payers for remote jobs | More health systems bill for MyChart | Evernorth to launch weight loss drug service | Elevance to offer smartphones to Medicaid members | Ky. system drops UnitedHealth, Centene MA

January 10, 2024

• • CVS braces for MA pressure | Why Cigna isn't buying providers | Cuban inks partnership with startup payer | Payer M&A to watch in '24 | 12 UnitedHealth updates

January 09, 2024

• • Walgreens to pay Humana $360M | CVS still in 'early innings' of Aetna merger | 3 providers being bought by payers | Least competitive commercial markets | 4 Ozempic updates

January 08, 2024

• • Elevance sues HHS over MA changes | Price transparency compliance in '24 | CMS to cut 2 Centene MA plans | Amazon partnership targets digital benefits | Largest MA insurer by state

January 05, 2024

• • UnitedHealth accuses former execs of theft | CVS shuffles leadership | Memorial Hermann drops Humana MA | Mark Cuban: CEOs 'waste a sh-tload' on healthcare | Eli Lilly to sell weight loss drugs direct to consumer

January 04, 2024

• • Cigna nears MA sale to HCSC | Optum, SSM Health end partnership | Essence-Stanford MA plan exits Calif. | Centene to pay $26M in SC Medicaid settlement | TikTok parent eyes healthcare

January 03, 2024

• • Layoffs at Blue Shield Calif. | Optum eyes Ore. clinics | MA startup closes $175M funding round | McKinsey to pay $78M for health plan settlement | 5 recent payer lawsuits

January 02, 2024

• • UnitedHealthcare, Prisma Health split | New price transparency rules take effect | The 2-midnight rule and MA: 6 notes | Where UnitedHealth has largest MA market share | 11 billing fraud cases

December 29, 2023

• • UnitedHealth to sell Brazil unit | Top 10 payer stories of '23 | 'Wellness chatbots' join benefits plans | The top Googled health questions | 250 payer exec moves this year

December 28, 2023

• • Senators decry MA long-term care denials | Inside Elevance's 'food as medicine' strategy | 15 payers that cut jobs in '23 | 15 top execs that left UnitedHealth this year | BCBS Mont. names president

December 27, 2023

• • UnitedHealth offered $610M for Brazil unit | 9 execs that left Cigna this year | BCBS Ill., Springfield Clinic end 2-year dispute | Optum's behavioral strategy: 3 notes | 10 key MA updates in '23

December 22, 2023

• • UnitedHealth's '23 in 10 headlines | FTC merger enforcement hits high | HHS among top agencies using AI | Workers want 'quiet management' | 10 prior auth updates

December 21, 2023

• • 5 key MA changes in '24 | Kaiser cuts 79 admin jobs | What BCBS CEOs told Becker's this year | More systems limit weight loss drug coverage | 10 MA updates

December 20, 2023

• • Payers hire malpractice-prone physicians: Report | HHS rebukes states for high child Medicaid losses | Feds want Humana's MA suit tossed | The $1B firm sidestepping insurers for surgeries | 12 UnitedHealth updates

December 19, 2023

• • Hospitals seek MA star ratings changes | CareFirst sues J&J over biosimilars | Steward faces false claims suit | Feds update merger guidelines | Healthcare's most stressful jobs

December 18, 2023

• • Elevance, HCSC eye Cigna's MA business | Kraft drops Aetna suit | Molina cuts purchase price for Bright's MA business | Cuban inks PBM partnership | 3 key Medicare changes in '24

December 15, 2023

• • The most competitive MA markets | BCBS La.-Elevance deal back on | Payers commit to Biden's AI principles | What 5 Aetna leaders told Becker's in '23 | 26 trends payer execs are watching

December 14, 2023

• • The most competitive commercial markets | 45% of group market can be disrupted: Centene CEO | Healthcare spending hits $4.5 trillion | BCBS Mich. CEO talks 17-year legacy | 19 best-managed healthcare cos.

December 13, 2023

• • Humana sued over MA denials | Jury awards ex-Kaiser nurse $41M | The layoff runway lengthens | Optum Rx to launch weight loss program | 7 Medicaid updates

December 12, 2023

• • House passes Lower Costs, More Transparency Act | Kaiser cutting 115 jobs | Cigna still eyeing MA sale | UnitedHealth exec to lead AHIP | 10 Optum updates

December 11, 2023

• • Cigna-Humana merger canceled | How BCBS is using price transparency data | What's blocking the SCAN-CareOregon deal? | Calif. Medicaid overhaul gets mixed reviews | 7 prior auth updates

December 08, 2023

• • Is the MA 'gold rush' over? | Biden to beef up M&A reviews | UnitedHealth MA ads labeled 'misleading' | NY weighs noncompete ban | Walmart hires hospital execs

December 07, 2023

• • States eye payers' AI use | GOP wants to take on 'big insurance' | BCBS La., Elevance deal gets more pushback | Aetna's plan to accelerate VBC | 100 hospitals cutting jobs

December 06, 2023

• • Cuban's effect on drug pricing | 50 states ranked by health: UnitedHealth | 3 most powerful women in insurance | Leapfrog's 132 top hospitals | Ky. system to drop MA plans

December 05, 2023

• • CMS may withhold Medicaid funds over unwinding issues | ACA regains attention for '24 election | CVS reboots care delivery strategy | Adventist, Blue Shield of Calif. split | Texas liquidates Bright

December 04, 2023

• • UnitedHealth CEO talks MA changes | DeSantis wants to 'supersede Obamacare' | Optum MA outperforms Medicare | Anthem Va., Aledade partner | 30 best payers for LGBTQ employees

December 01, 2023

• • HCSC eyes Cigna's MA business | UnitedHealth's 5 growth priorities | NC Medicaid expansion begins | Bill Gates predicts 3-day workweek | 15 exec moves in November

November 30, 2023

• • Cigna, Humana 'in talks' to merge | UnitedHealth projects $400B year-end revenue | Why BCBS Ariz. wants to look like Kaiser | CMS cuts improper Medicaid payments | BCBS Mich. inks tentative deal after strike

November 29, 2023

• • Optum has 90K physicians | Trump vows to replace ACA | Bipartisan anger grows over MA denials | CVS sues US over denied tax deductions | Amazon's pay for 17 healthcare jobs

November 28, 2023

• • UnitedHealth, Cigna suits spark AI questions | Amazon, healthcare + hubris | Cost Plus inks specialty drug partnership | Mounjaro more effective than Ozempic: Study | Optum taps home care CEO

November 27, 2023

• • AHA: MA denials up 56% | Optum facing antitrust suit from Calif. system | Pa. system drops Cigna | Blues become providers | 10 Epic updates

November 24, 2023

• • Hospitals' next MA move | The Blues become providers | A short-lived CEO argued he could be automated | Moody's: 2023 insurance outlook is stable | 9 MA updates

November 22, 2023

• • Payers ignoring new MA rules, AHA says | Self-pay ED visits spike post-redeterminations | UnitedHealth ASC deal facing scrutiny | CMS publishes SDOH playbook | The newest C-suite leader

November 21, 2023

• • CMS overpaid MA $16.6B | 25 states 'failing' at Medicaid unwinding | 6 payers expanding ACA plans | 15 'overpaid' healthcare CEOs | 10 UnitedHealth updates

November 20, 2023

• • 3 'overpaid' payer CEOs | Texans convicted in $145M fraud scheme against BCBS | Tenn. extends Medicaid contracts | 'Shrinkflation' hits healthcare | 4 recent MA study findings

November 17, 2023

• • CMS pitches new exchange rules | 'Worse than people can imagine': 5 Medicaid unwinding updates | 4 payers launching MA plans | Payer mix in largest for-profit systems | 7 prior auth updates

November 16, 2023

• • Feds drop UnitedHealth antitrust case | More hospitals cut MA | Novo Nordisk ups weight loss drug manufacturing | MA ads still under scrutiny | 11 recent payer exec moves

November 15, 2023

• • UnitedHealth sued over MA denials | Froedtert buys Ascension's health plan stake | Cigna follows Cuban's drug pricing lead | 5 states consider weight loss drug coverage | 10 MA updates

November 14, 2023

• • Feds ramp up MA scrutiny | AMA urges insurers to cover weight loss drugs | Inside Select Health's Cost Plus partnership | UnitedHealth gives aid to Israel, Gaza | 8 Cigna exec departures this year

November 13, 2023

• • BCBS sued over alleged data leak to TikTok | CMS pitches MA audit appeal changes | NY payer cutting 68 jobs | Mayo to limit employee weight loss drug coverage | UnitedHealth's provider network size by state

November 10, 2023

• • 15 payers cutting jobs | CMS imposes hiring freeze | Ex-Optum employee fined $13M for fraud | MA beats Medicare in hospital readmissions: Report | Epic expands payer reach

November 09, 2023

• • 14 payers exiting MA | Optum closes clinics | 23 execs' top priorities for '24 | FDA approves Eli Lilly's weight loss drug | What sold CVS on Oak Street

November 08, 2023

• • CMS pitches equitable MA prior auth | Elevance settles exec noncompete case | Neb. fines Bright $1M | Where Cigna sees opportunity in GLP-1s | Amazon adds healthcare to Prime

November 07, 2023

• • Cigna eyes MA exit | CMS proposes MA marketing, broker reform | Payers ranked by Q3 MLRs | BCBS Mass. cutting prior auths | Envision snags former UnitedHealth CEO

November 06, 2023

• • Payers ranked by Q3 enrollment | Prisma-UnitedHealth contract fight continues | Kaiser posts $239M Q3 profit | Optum leaving 54-acre campus | Allstate selling health benefits business

November 03, 2023

• • Payers' revenues, profits in Q3 | More CVS job cuts | CMS drops 4 final payment rules | VP Harris spotlights payers' AI use | UnitedHealth's total membership by state

November 02, 2023

• • Centene, Walmart partner | UnitedHealth sued over layoffs | Cigna posts $1.4B Q3 profit | Will hospitals regret their MA divorce? | Aetna expands ACA plans

November 01, 2023

• • CVS, Humana post Q3 earnings | UnitedHealth begins 2nd wave of prior auth cuts | ACA open enrollment: 5 updates | Employers eye deductible-free plans | 21 recent payer exec moves

October 31, 2023

• • DOJ eyes payer M&A | BCBS companies ranked by MLRs | Where payer prices are highest, lowest | NC treasurer urges end to weight loss drug coverage | The best hospital in each state

October 30, 2023

• • More Aetna layoffs | Feds pitch No Surprises changes | CMS: Payers to lose $1B+ over Bright, Friday exits | Walkouts could surprise CVS, Walgreens today | 10 UnitedHealth updates

October 27, 2023

• • Former MA exec charged in fraud scheme | Most profitable BCBS companies | Humana's CMO on health literacy | UHS CEO: Insurers increasingly aggressive | Highest-paying healthcare jobs

October 26, 2023

• • Payer-provider contract fights flare up | Judge upholds BCBS antitrust settlement | Feds to appeal another No Surprises ruling | HDHP growth slows | 15 MA updates

October 25, 2023

• • Cigna cuts jobs | BCBS plans ranked by revenue | 8 provider purchases by payers | 15 Optum exec departures this year | ACOs with biggest cost savings

October 24, 2023

• • Centene profits down 36% | Largest payer in each state | Why 1 payer CEO calls MA an unlevel playing field | Optum expanding in Wash. | Trinity investing 'aggressively' in MA

October 23, 2023

• • Top MA plan in each state | BCBS NC to buy urgent care clinics | Hospitals stop covering weight loss drugs | Payers decry mental health parity rules | Inside Elevance's rebrand

October 20, 2023

• • Optum Health pivots amid MA changes | Consumers happier with insurers than hospitals | CMS axes Ill. Part D plan | Wash. fines UnitedHealth | 13 payer exec moves

October 19, 2023

• • Optum Insight CEO exits | Hospitals sour on MA | Commercial premiums surge | Elevance faces $500M hit over star ratings | Top payers for customer satisfaction

October 18, 2023

• • Elevance profits down 20% | 50 MA plans below 3 stars | Highmark to 'transform' with Google's generative AI | Physician charged in Aetna, Premera fraud scheme | Walgreens, Alignment launch MA plan

October 17, 2023

• • 5-star MA plans in '24 | Optum Insight revenue up 35% | MA ratings up for CVS, down at Elevance | CFOs eye Zelle, Venmo | 11 recent UnitedHealth departures

October 16, 2023

• • MA star ratings decline | UnitedHealth wants cheaper Ozempic | Medicare open enrollment begins: 5 changes | 2 Centene leaders depart | CVS CFO takes leave

October 13, 2023

• • UnitedHealth posts $5.8B Q3 profit | Kaiser reaches $200M behavioral settlement | Feds to limit predictive tools for MA | 29 ways payers can boost equity | 10 MA updates

October 12, 2023

• • Elevance cuts jobs | Envision plans its comeback | Meet Humana's next CEO | 10 biggest markets for MA ads | NC's unique Medicaid challenge

October 11, 2023

• • New CEOs at Humana, Walgreens | BCBS Mich, Vt. affiliation cleared | Will employers squeeze hospitals? | Kaiser on alert for 2nd strike | 6 health systems launching MA plans

October 10, 2023

• • Kaiser cuts jobs in Calif. | How UnitedHealth lowered employer costs by 15% | The 'wild west' of MA | Mark Cuban racks up collaborators | GLP-1 coverage could double in '24

October 09, 2023

• • Optum, Uber partner | Calif. takes step toward universal coverage | UnitedHealth taps exchange CEO | Ore. system drops some MA plans | Walmart: Ozempic causing less food buying

October 06, 2023

• • OIG: MA overpaid Aetna by $25M | Why BCBS Mich. is cutting prior auths | 6 grocers with MA plans | Why Walmart doesn't partner with hospitals | 7 Centene updates

October 05, 2023

• • Lawmakers: Scrutinize United-Amedisys deal | 75K Kaiser workers on strike | 3 states dropping payers from Medicaid contracts | Optum, Wis. system partner | 7 Elevance updates

October 04, 2023

• • The state of MA in '23 | Ind. drops Molina from Medicaid contract | UnitedHealth enhances UCard | Walgreens eyes ex-Cigna exec for CEO | 11 best payer workplaces for parents

October 03, 2023

• • Payers expanding MA for '24 | Unions renew billing fight with BCBS Mass. | Instacart, Alignment launching MA plan | UnitedHealth increasing exchange plans | 10 'overpaid' CEOs' path to the top

October 02, 2023

• • Cigna settles MA fraud allegations | Lawmakers launch Medicaid prior auth probe | Meijer, BCBS Mich. launch MA plan | How Aetna is using Signify, Oak Street | 19 recent payer exec moves

September 29, 2023

• • Optum eyes Conn. surgery center | Payers with best telehealth in '23 | Why 5 MA plans are top-rated by members | How Uber Eats is diving into healthcare | GuideWell snags Caremark CFO

September 28, 2023

• • Why hospitals are ditching Medicare Advantage | Aetna leader on building successful VBC models | Payers bet big on individual market | Ozempic prescriptions soar | 9 UnitedHealth updates

September 27, 2023

• • Centene cutting 2K jobs | Payer execs defend vacation | Shutdown could disrupt Medicaid unwinding | 75K Kaiser workers plan strike | 10 CVS exec departures

September 26, 2023

• • Elevance, BCBS La. halt deal | Cigna facing more lawsuits over claims denials | Cano sells centers to Humana | Feds want to triple No Surprises arbitration fee | NC expanding Medicaid Dec. 1

September 25, 2023

• • Kaiser snags UnitedHealth exec | Payers go all in on Cuban's drug co. | HHS preps for shutdown | CommonSpirit lays off 2,000 | How MA is marketed on TV

September 22, 2023

• • UnitedHealth cuts MA plans | HHS halts Medicaid unwinding in 30 states | How MA is sold on TV | Ore. to create new public plan | 8 Cigna updates

September 21, 2023

• • UnitedHealth sued over vaccine mandate | Former Elevance exec can join Molina, judge rules | Are payers complying with price transparency? | CMS audits Texas over Medicaid unwinding | The best Medicaid plans of '23

September 20, 2023

• • Cuban teams up with Select Health | Best MA plans in '23 | AMA: Payers' prior auth cuts not 'major progress' | 18 payer CEO moves | 7 Aetna updates

September 19, 2023

• • Optum to revamp clinics | Best commercial plans by state | 26% of employers to cover weight loss drugs | Kaiser taps regional president | 4 value-based programs to know

September 18, 2023

• • Best-rated health plans of '23 | UnitedHealth moves to Optum campus | Payers sue over exec moves | Most-uninsured cities in US | 10 Medicaid updates

September 15, 2023

• • Cigna sued by shareholder | BCBS Mich. CEO to retire | 25 payer execs' best advice | 5 prior auth updates | Most uninsured states in 2022

September 13, 2023

• • Elevance sues former exec | Payers drop senior care co. | Blue Shield Calif. CEO on challenging healthcare's status quo | Texas awards long-term Medicaid contracts | A budget blindspot in healthcare

September 12, 2023

• • Layoffs at Optum: 3 updates | Hawaii halts redeterminations | Amedisys shareholders OK Optum deal | Medicaid weight loss drug spending tops $1B | Walgreens to expand primary care

September 11, 2023

• • Prisma denied restraining order against UnitedHealth | Walmart eyes ChenMed buy | Health system-payer negotiations go awry | Gym chain limits hours for Medicare members | AHIP taps interim CEO

September 08, 2023

• • CVS revamps C-suite | BCBS Mich. cutting prior auth 20% | Mark Cuban's pharmacy: 5 updates | Where MA falls short, per hospital CEO | 5 recent payer lawsuits

September 07, 2023

• • What's next in the No Surprises legal fight? | Where MA and Medicare spending differ | 1 in 3 HHS appointees hop to industry jobs | Feds give millions to Colo. public plan | 6 UnitedHealth updates

September 06, 2023

• • Blue Shield Calif. CEO details PBM shakeup | CMS debuts pop health payments | Oscar snags more Aetna execs | Elevance named best healthcare employer | Centene continues selloffs

September 05, 2023

• • Humana sues over MA clawbacks | UnitedHealth hits back at Prisma lawsuit | US News hospitals with MyChart fees | Regence taps Oregon president | 8 payer M&A updates

September 01, 2023

• • UnitedHealth starts prior auth cuts | CEOs out at Walgreens, One Medical | CMS suspends No Surprises arbitration | GoodRx launches insurance tool | 17 payer exec moves in August

August 31, 2023

• • CMS to states: Address Medicaid losses | 3 M&A deals under scrutiny | 67 healthcare leaders under 40 | Highmark mandates hybrid schedule | UnitedHealth taps chief security officer

August 30, 2023

• • Prisma files for restraining order against UnitedHealth | Humana launches in-home primary care | 20 highest-paid healthcare CEOs | Anthem expands virtual-first plans | 4 payers exiting markets

August 29, 2023

• • Bon Secours sues Anthem over unpaid claims | CMS taps 10 drugs for negotiations | UnitedHealth's ACA prior auth cuts by category | Wegovy reduces heart failure symptoms: Study | Payer execs on future of care delivery

August 28, 2023

• • HHS loses 4th No Surprises Act lawsuit | Centene sells UK hospital group | Payers respond to Maui wildfires | Can small payers keep up with giants' evolution? | Cigna exits ACA markets

August 25, 2023

• • 150 things to know about the 'Big 6' | Texas HHS workers sound alarm on Medicaid unwinding | States with highest employer premiums | How Risant aims to outshine disruptors | 10 UnitedHealth updates

August 24, 2023

• • Where CVS is conducting layoffs | Cigna cutting prior auth 25% | Amazon tiers healthcare prices | 5 co-branded MA plans | States with highest employer premiums

August 23, 2023

• • Fla. sued over Medicaid unwinding | Anthem Va. slaps Bon Secours with cease and desist | Calif. health system latest to side-eye MA | A No Surprises Act timeline | 5 Ozempic updates

August 22, 2023

• • Layoffs at Optum clinics | Top MA plans in '23 | Risant's plan to outshine disruptors | What Netflix chaos holds for healthcare | 100 things to know about Medicaid

August 21, 2023

• • Layoffs hit Aetna | UnitedHealth's MA prior auth cuts by category | Ozempic, Wegovy list prices higher in US | BCBS La., Elevance deal scrutinized | 7 payers in new markets

August 18, 2023

• • 10 payer layoffs | Former Kaiser CEO questions Risant | Insurance startups zero in on employers | UnitedHealth could hit $1T value by 2030 | What's next for Intermountain's health plan?

August 17, 2023

• • Blue Shield Calif. teams with Mark Cuban, Amazon pharmacies | Hospitals dropping MA | Lawsuit questions Amedisys-UnitedHealth deal | 8 positions being cut at Aetna | Where ACA premiums are rising, falling in '24

August 16, 2023

• • Layoffs at Aetna | Ozempic could join CMS drug price talks | Ore. system urges patients to drop MA | Payers pitching the highest rate hikes for '24 | 8 Elevance updates

August 15, 2023

• • Inside UnitedHealth's commercial prior auth cuts | Mayo to bill for MyChart | Payers ranked by MA bonus payments in '23 | Cano bankruptcy likely | 10 recent payer exec moves

August 14, 2023

• • Layoffs hit Optum | NYC judge blocks Aetna MA contract | UnitedHealth gets OK to acquire UK company | States push back on insurers' proposed rate hikes | 6 prior auth updates

August 11, 2023

• • DOJ eyes UnitedHealth-Amedisys deal | 36 states fall short on Medicaid unwinding | Cano to cut 17% of workforce | AdventHealth sues MultiPlan for alleged price fixing | Amazon, CVS face off on senior care

August 10, 2023

• • The future of health insurance, per 19 execs | UnitedHealth to mentor 10 more startups | Healthcare M&A hits a low | Payers ranked by Medicaid membership | Ga. hospital sues Cigna

August 09, 2023

• • Payer mix in the largest for-profit systems | Why a UnitedHealth employee joined the Bachelorette | 7 ways payers are containing GLP-1 costs | Counties with the highest, lowest uninsured rates | The 3% raise is no longer enough

August 08, 2023

• • Elevance taps new CFO | 3 payers reverse policies after pushback | SD system drops all MA plans | Weight loss drugs boost payers' pharmacy lines | 10 UnitedHealth updates

August 07, 2023

• • Optum names new president | HHS loses another No Surprises lawsuit | Humana reverses prior auth policy | US hits record uninsured rate | 10 Medicaid updates

August 04, 2023

• • Weight loss drug coverage hits a wall | Payers ranked by Q2 profits | CVS job cuts have unclear effect on Aetna | CEO role loses luster | 9 Medicare Advantage updates

August 03, 2023

• • Cigna posts $1.5B Q2 profit | Lawmakers propose MA gold-carding | Job cuts hit the C-suite | Has Medicaid unwinding been too chaotic? | UnitedHealthcare puts $11M behind SDOH

August 02, 2023

• • DOL sues UnitedHealth over claims denials | CVS + Humana post Q2 earnings | Payers ranked by Part D market share | CMS to boost hospital pay 3.1% | Centene loses 263K Medicaid members

August 01, 2023

• • UnitedHealth's prior auth cuts begin Sept. 1 | CVS Health to cut 5,000 jobs | 15 best payers for women | 23 exec moves in July | US News: No. 1 hospitals by state

July 31, 2023

• • Payers, AMA urge CMS to drop prior auth reforms | UHS favors 'patients whose insurance will pay us more' | Centene could lose last 4-star MA contract | Molina posts 25% income growth in Q2 | 10 best, worst states for healthcare

July 28, 2023

• • Centene posts $1B profit in Q2 | Prior auth reform bill advances | 5 Cigna exec departures | Sanford, Fairview halt merger | Nevada last to liquidate Friday Health Plans

July 27, 2023

• • Cigna hits back on claims denial allegations | Meet UnitedHealth's new chief physician | U of Texas drops weight loss drugs | The biggest misconceptions about prior auth | 483 hospitals with 5 stars from CMS

July 26, 2023

• • Where Medicaid negotiates over weight loss drugs | 4 prior auth updates | 8 MA study findings | How Elevance Health is using AI | Meet UnitedHealth's C-suite

July 25, 2023

• • Cigna sued over claims algorithm | 7 payers' Medicaid prior auth denial rates | Biden pitches tougher mental health parity rules | C-suite's fastest growing role hits a snag | 18 health systems billing for MyChart

July 24, 2023

• • The fight over claims data | C-suite pay cuts continue | Ascension drops weight loss drug coverage | Elevance loses 135K Medicaid members | 8 Humana updates

July 21, 2023

• • What outsourcing to Optum is like | How 7 payers use AI | The biggest misconceptions about payers, per 24 execs | 20 most socially responsible hospitals | Calif. prior auth bill advances

July 20, 2023

• • CMS halts Medicaid unwinding in some states | UnitedHealth names chief physician | 9 highest paid payer CEOs | 100 fittest cities in America, per Elevance | 10 Medicare Advantage updates

July 19, 2023

• • Optum Health taps CEO | Elevance posts $1.9B Q2 profit | How payer exec salaries stack up | Most socially responsible hospital in each state | Calif. Medical Assoc. can sue Aetna, court says

July 18, 2023

• • UnitedHealth expects higher MA costs | 17 payers among best companies for disability inclusion | HCSC boosts prior auth with AI | More than 2M disenrolled from Medicaid | 5 payers entering new markets

July 17, 2023

• • 50 things to know about Optum | Is price transparency lowering costs? | CMS floats physician, outpatient rules: 15 notes | 25 payers on Threads | 7 recent exec moves

July 14, 2023

• • UnitedHealth posts $5.5B Q2 profit | Ozempic demand driving up premiums | CMS pitches price transparency changes | How the 'Amazon effect' is changing the insurance industry | 7 MA updates

July 13, 2023

• • The ongoing BCBS reshuffle explained | Lawmakers push more price transparency bills | Many MA members financially unstable: Humana | Why CVS, Optum spent $17B on home care | Johns Hopkins rebrands insurance plan

July 12, 2023

• • The limit to weight loss drugs, per Prime Therapeutics | Johns Hopkins enacts MyChart fees | What Centene's CEO learned in year 1 | ACA risk adjustment payments on rise | 10 Medicaid updates

July 11, 2023

• • Payers pitch rate hikes amid Ozempic spike | The unhealthiest county in each state | Medicaid affected in Anthem, Bon Secours pay fight | CVS-owned pharmacy to lay off 195 | 11 UnitedHealth updates

July 10, 2023

• • Employers sue for claims data | 16 payers among nation's 'greatest workplaces' | Judge pauses Aetna's NYC MA plan | Optum Everycare CEO exits | The healthiest county in each state

July 07, 2023

• • Biden takes aim at 'junk' plans | FDA clears Leqembi | 6 MA study findings | Ark. systems splits with UnitedHealthcare | 4 Google healthcare job openings

July 06, 2023

• • Idaho drops Optum for Centene | Ohio eyes Medicaid work rules | Eli Lilly crowned world's largest healthcare co. | Inside Elevance's suicide reduction program | 10 key Cigna updates in '23

July 05, 2023

• • Kraft sues Aetna for claims data | CMS floats home care pay cut | No Ozempic before surgery: New guidance | 10 states with largest employee health plans | 7 prior auth updates in '23

July 03, 2023

• • What makes the top health plans unique? | 35 exec moves in June | BCBS Assoc. sues company for blue cross logo | Why Oscar posted its AI research | Centene CEO: Behavioral costs rising

June 30, 2023

• • Molina to buy Bright's Calif. MA plan | FTC floats stricter merger reviews | UnitedHealth waives virtual visit costs | BCBS Ariz. launches primary care company | 78 charged in $2.5B fraud scheme

June 29, 2023

• • Optum, Virginia Mason partner | States consider Medicaid unwinding pause | 8 Cost Plus Drug Co. moves | The two-midnight rule and MA: 6 notes | Ore. looks to create universal care board

June 28, 2023

• • Pickleball: An unlikely threat for insurers | Former Highmark employee accused of HSA theft | Cigna names Medicare leader | 5 recent payer rebrands | 8 key Centene updates in '23

June 27, 2023

• • Off-label Ozempic use concerns payers | UnitedHealth's chief growth officer departs | Fitch: Payers to weather rising utilization | Humana expanding CenterWell | 9 prior auth updates

June 26, 2023

• • Optum to buy Amedisys | 8 payers cutting jobs | Elevance names 'food as medicine' director | What to know about NYC's new MA plan | 7 Aetna updates

June 23, 2023

• • 50 things to know about CVS | Lawmakers want prior auth reform to go further | Friday Health laying off all staff | States with the best healthcare systems | 7 Medicare Advantage updates

June 22, 2023

• • Highmark lays off 100+ | UnitedHealth shareholders reject health equity, lobbying proposals | Elevance CEO: Weight loss drug impact unclear | Optum's AI chief departs | 13 recent CMS moves

June 21, 2023

• • BCBS costs on the rise | CVS appeals exec noncompete case | Mark Cuban's pharmacy becomes an insurance benefit | Novo Nordisk pushes for Medicare coverage of Ozempic | 8 Optum updates

June 20, 2023

• • CVS, Walgreens at forefront of Medicaid unwinding | Which C-suite leaders are promoted to CEO? | Cano Health CEO exits | NYC Aetna MA plan moves ahead | 6 Ozempic updates

June 16, 2023

• • How much do BCBS CEOs earn? | Humana echos rising medical cost warning | Calif. fines Kaiser's health plan | 9 leaders on Medicaid coverage losses | 6 healthcare bankruptcies

June 15, 2023

• • 22 exec moves in June | 'We've normalized the abnormal' in healthcare billing | Walgreens taps clinical trial partner | AMA urges oversight of AI in prior auth | Optum home care linked to better MA outcomes: Study

June 14, 2023

• • Medical costs are up: UnitedHealthcare exec | Empire BCBS rebranding | MA overpayments could exceed $75B in '23 | CMS to states: Slow down redeterminations | Centene completes AI platform sale

June 13, 2023

• • Why Centene is selling non-core businesses | Becerra 'deeply concerned' over Medicaid losses | Disenrollments top 1 million | Payers crack down on Ozempic prescriptions | Mass. payer facing 4 suits over data breach

June 12, 2023

• • HHS nears ACA preventive coverage deal | NYC halts Aetna MA plan | All eyes on Medicare for weight loss drug coverage | AHA: Payers burdening physician-owned practices | 10 UnitedHealth updates

June 09, 2023

• • Payers' AI use in Senate spotlight | CMS to pilot primary care revamp | 13 payer leaders' best Medicaid unwinding advice | UnitedHealthcare, Cigna halt policies after pushback | Anthem BCBS, Bon Secours Mercy at odds over payments

June 08, 2023

• • CMS 'in talks' about obesity drugs | 6 payers with best leadership | Fitch: Insurer headwinds mounting in '23 | BCBS Hawaii responds to exec pay pushback | 10 Medicaid updates

June 07, 2023

• • Aetna, Optum face 'dummy code' class action | Friday Health sued by former COO | Humana opens 250 senior care centers | Empire BCBS CEO tapped for top Elevance role | How major payers compare on price transparency

June 06, 2023

• • Former Cigna exec barred from CVS | 15 payer CEO moves in '23 | High copays linked to lower weight loss drug use | Inside Kaiser's health plan growth | 4 payers exit Colo.

June 05, 2023

• • Optum pitches Amedisys merger | Fortune 500's top 5 payers | CMS vaccine rule officially over | Aetna's former CMO to advise weight loss startup | Google, Humana partner on insurance cards

June 02, 2023

• • Friday Health shutters | Ford sues BCBS over antitrust claims | UnitedHealthcare's new GI policy: 7 details | How big payers compare on price transparency | 7 MA updates

June 01, 2023

• • Top commercial plans of '23 | UnitedHealthcare scraps new GI policy | Medicaid losses for procedural reasons in 5 states | Hospital margins break even | NYC retirees challenge Aetna MA plan

May 31, 2023

• • CMS addresses Medicaid losses | States ranked by MA members | What experts think about the size of CVS, UnitedHealth | NC clears BCBS restructuring | Ill. to build state exchange | Debate continues over UnitedHealth's GI policy | 21 exec moves in May

May 30, 2023

• • Medicaid work rules a no-go | Payer mix in every state | Hospitals with best commercial rates for mental healthcare | CVS, Amazon shuttering health businesses | Elevance's 'secret sauce' to boosting maternal outcomes | Payers ranked by Medicaid members

May 26, 2023

• • Avg. hospital payer mix by state | Walgreens wants $642M Humana award vacated | CVS expects $1B revenue drop | 8 best payers for new grads | Where UPMC Health Plan is growing | CBO: Uninsured rate at 10% by 2033

May 25, 2023

• • June 1 Medicare payments at risk | 8 BCBS affiliate earnings in '22 | 1 in 4 Medicaid enrollees don't know where to find other coverage | AHIP president resigning | Harvard Pilgrim reports ransomware attack | BCBS Neb. names CEO | 8 Cigna updates

May 24, 2023

• • CMS pitches PBM price transparency | Payers ranked by Q1 commercial members | Debt ceiling talks focus on Medicaid work rules | 8 most community-minded insurers | Ozempic pill sees 15% weight loss | Virtual-first health plans: 4 updates

May 23, 2023

• • Employers wary of weight loss drugs | How UnitedHealth came to dominate healthcare | Calif. pitches Medicaid boost | Cigna delays modifier 25 policy | Centene COO retiring | Bright completes reverse stock split | 6 MA study findings

May 22, 2023

• • Medicaid unwinding off to rocky start | 6 limitations with price transparency data, per Elevance | 175 groups oppose UnitedHealth's GI prior auth policy | Lawmakers press payers on MA claims denials | Top earners at for-profit health systems

May 19, 2023

• • 1:1 with Dr. Jaewon Ryu on Risant Health | US debt ceiling breach may be catastrophic for payers | UPMC faces antitrust suit | Optum's former CMO joins WelbeHealth | Top conditions driving self-insured claims | Unhealthiest county in each state

May 18, 2023

• • 5 new Risant Health details | FTC expands PBM probe | 'Medicare for All' bill reintroduced | From PE to bankruptcy: Envision's last 5 years | Payers expect $1.1B in MLR rebates | BCBS Mass. adds physician groups | Unhealthiest states for seniors in '23

May 17, 2023

• • Regulators eye Cigna after unreviewed claims report | Optum's chief consumer exec departs | Wis. system drops Envision | Healthiest states for seniors, per UnitedHealth | Why 10 hospitals were at risk of losing CMS funding | 8 Centene updates

May 16, 2023

• • Payers put AI to work | Centene shareholders reject exec pay proposals | Court pauses ACA preventive care ruling | Cityblock Health to lay off 60 | CVS to close clinical trials unit | Ozempic alternatives worry health experts | 7 Optum exec moves

May 15, 2023

• • Envision files for bankruptcy | 50 things to know about UnitedHealth Group | Highest-paid healthcare CEOs in '22 | Insurtechs lost $282M in Q1 | Independence Blue Cross details prior auth pilot | 10 payer exec moves in May

May 12, 2023

• • Envision plans layoffs | Payers ranked by MA membership | Aetna, UnitedHealthcare settle overcharging allegations | Clover posts $72.6M loss in Q1 | 30 states pitching prior auth reforms

May 11, 2023

• • Envision to file for bankruptcy | Centene shareholders reject exec pay proposals | Oscar Health posts $39.6M Q1 loss | Friday Health Plan halts Colo. enrollments | Humana's Inclusa acquisition passes state reviews

May 10, 2023

• • Oscar exiting Calif. market | 7 payer M&A updates | Leaders weigh in on Kaiser-Geisinger deal | What 5 payer leaders said about GLP-1 drugs | 12 top healthcare companies by revenue

May 09, 2023

• • Payers ranked by Q1 membership growth | Centene shareholders zero in on exec pay | 11 billing fraud cases | Bright Health posts $169M loss in Q1 | 73,000 lose Medicaid coverage in Ark.

May 08, 2023

• • Payers ranked by Q1 profit | Ransomware gang hits Calif. health plan | CMS ditches fight over hospital's candle | Kaiser adds 120,000 health plan members | 9 Aetna updates

May 05, 2023

• • Cigna posts $1.3B Q1 profit | Best payers for women execs | Minn. orders payer to shut down | How BCBS Ariz. is navigating Medicaid redeterminations | Hospital could lose CMS funding over candle | 5 Q's MA data doesn't answer

May 04, 2023

• • Weight-loss drug sales up 162% | Texan pleads guilty in $7M COVID testing scheme | Where insurer CEO pay has risen most | CVS expects MA boost in '23 | Bright names CFO | Carbons Health airs dispute with Anthem | 7 MA updates

May 03, 2023

• • CVS posts $2.1B Q1 profit | Ga. pitches state-run exchange | Are Medicaid work requirements lawful? | HHS to scrap vaccine rules | Calif. physician pays $24M to settle billing fraud claims | 10 best states for healthcare

May 02, 2023

• • CVS buys Oak Street | MA enrollment tops Medicare | BCBS Mich., Vt. pitch affiliation | UnitedHealthcare to pay Envision $91M | RN pay by state | Why Ga. is seeking Medicaid hackers | 8 Elevance Health updates

May 01, 2023

• • Where Medicaid covers weight-loss drugs | 12 UnitedHealth updates | Kaiser deal to 'turbo-boost' Geisinger | 4 ways ChatGPT can help payers | BCBS Tenn. selling campus | 17 payer exec moves in April

April 28, 2023

• • CMS pitches Medicaid reforms | Bright may exit insurance business | Geisinger to keep name in Kaiser deal | Inside Optum's physician acquisition strategy | CMS fines hospitals over price transparency | 7 Centene updates

April 27, 2023

• • Kaiser, Geisinger to combine | Insurers ranked by CEO-to-worker pay ratios | CMS gets stricter with hospital price transparency | Walmart Health expanding | Optum Health names regional CEO | 17 top payers for diversity: Forbes

April 26, 2023

• • Humana posts $1.3B Q1 profit | CBO: 600K Medicaid losses under work proposal | UnitedHealth's top lawyer paid $11M amid Change fight | North Carolina caps Friday Health enrollment | Hourly nurse pay in all 50 states | Highest-paid payer CFOs

April 25, 2023

• • UnitedHealth's top 5 earners | Centene posts $1.1B Q1 profit | Clover risks Nasdaq delisting | Elevance boosts AI-powered concierge care | Cuban hasn't 'f—ed up' pharma yet | Lawmakers push for Medicare at home | Top 10 payers in '23

April 24, 2023

• • Highest-paid payer CEOs | Manufacturers push Medicare to cover weight loss drugs | The denied claims most frustrating to physicians | What's next for price transparency? 5 notes | 6 top healthcare companies for career growth

April 21, 2023

• • 100 things to know about BCBS | Republicans push Medicaid work requirements | SSM Health sues Bright over unpaid claims | Elevance expanding post-acute care | Bizarre dreams follow Ozempic use | 8 Optum updates

April 20, 2023

• • 48 payers top price transparency scores | Elevance weighs in on weight loss drugs | Cuban launches pharmacy network | UnitedHealth's LHC to buy home health company | The ACA in 2023: 8 notes | CVS CEO among world's 'most influential'

April 19, 2023

• • Elevance posts $2B Q1 profit | 12 payers among 'most trustworthy companies' | Payers move to cover telehealth abortions | Fewer physicians taking Medicare, Medicaid patients | Biden pushes in-person work

April 18, 2023

• • CVS names Aetna president | 'Still a lot to learn' about new weight loss drugs: UnitedHealth CEO | CMS issues final ACA rule for '24 | Issues remain under No Surprises Act, report finds | Ala. warms to Medicaid expansion | 8 MA updates

April 17, 2023

• • UnitedHealth could cut prior auth another 10% | False Claims Act case heads to Supreme Court | Clover lays off 10% of workforce | Optum revenue hits $54B | Carelon opens 1st healthcare center | 10 payer exec moves

April 14, 2023

• • UnitedHealth's revenues up 15% | Optum dives into provider loans | How many people health insurers employ, state-by-state | Meet CVS Health's leadership team | Majority of payers using outcomes-based contracts

April 13, 2023

• • Google, Microsoft launch payer solutions | Biden expanding Medicaid, ACA to DACA recipients | Express Scripts adding drug price caps | Fla. seeking Medicaid bids | Anthem BCBS Va. taps new president | Optum has 70K+ physicians

April 12, 2023

• • DOJ seeking pause on Texas ACA ruling | The fastest growing MA startups | Ozempic's No. 1 competitor | LHC's workforce spurred UnitedHealth deal | Most payer physician directories are wrong: Study | 35 billionaires in US healthcare | 8 recent CMS moves

April 11, 2023

• • 10 exclusives from Mark Cuban | ProPublica: Cigna denies unreviewed claims | CMS pitches inpatient payment rule for '24 | Uninsured rates post-Medicaid unwinding, by state | Former Cano directors describe 'underperformance' | States with lowest MA rates

April 10, 2023

• • Optum buys 400+ physician group | CVS Health's top 5 earners | MA outperforms FFS Medicare in new clinical study | Layoffs loom at CommonSpirit | USPS seeking payer proposals for new health plan | Healthcare leaders to know in '23

April 07, 2023

• • Cigna CEO wants return to in-person work | 6 payers among best workplaces for LGBTQ | 10 prior auth updates | MA market penetration linked to less FFS postacute care | States ranked by annual household insurance spend | BCBS Tenn. taps 4 VPs

April 06, 2023

• • CMS finalizes MA prior auth reform | Walgreens to keep providing Medi-Cal benefits | Okla. takes over Friday Health's finances | Cuban's pharmacy adds more branded drugs | 10 healthiest, unhealthiest cities | 9 UnitedHealth updates

April 05, 2023

• • 15 specialties ranked by payer billings | Centene taps new chairman | Molina's 5 highest-paid execs | 8 Bright Health updates | How payers can prepare for 'year of compliance'

April 04, 2023

• • 15 payers among 'most innovative' companies | States weigh legal action over ACA preventive care ruling | ACA premiums increased 3.4% in 2023 | Elevance Health's top 5 earners | 4 Ozempic updates | AHIP backs HHS in copay coupon lawsuit | 10 MA updates

April 03, 2023

• • CVS Health exec returns to UnitedHealth + 22 March payer exec moves | Biden appeals ACA preventive coverage ruling | CMS to phase in MA risk adjustment changes | OIG: Cigna received $6.2M in MA overpayments

March 31, 2023

• • Medicaid unwinding begins | Texas judge strikes down ACA preventive coverage | CVS-Oak Street deal clears FTC scrutiny | 5 reactions to UnitedHealth's prior auth cuts | 149 Black healthcare leaders to know | Cigna's top 5 earners

March 30, 2023

• • UnitedHealthcare cutting prior auth by 20% | States ranked by estimated Medicaid losses | COVID national emergency could end before May | Centene's top 5 earners | 'Netflix-model' payer startup expands | 8 Cigna updates

March 29, 2023

• • Payers to cut prior auth. requirements | CVS buys Signify | AHA, AHIP challenge False Claims interpretation | How states manage Medicaid staff shortages | Centene names chief people officer | Payers ditch office space

March 28, 2023

• • Texas shuts down Friday Health | Former Aetna CEO to lead Oscar | NC expands Medicaid | Ohio sues PBMs for alleged price fixing | Calif. fines Health Net for improperly paid claims | Cigna, Aledade partner on senior care

March 27, 2023

• • CVS to close $8B Signify deal | After SVB, regulatory Qs swirl in health insurance | Payers shouldn't subsidize hospitals' investment losses: Economists | Senators question HHS sec. over MA rates | BCBS Minn. leaving HQ | Humana's top 5 earners

March 24, 2023

• • Cigna CEO faces deposition in CVS noncompete case | Tenn. takes over Bright's finances | 'Frivolous' claims bogging down No Surprises arbitration: HHS | FTC wants to tackle more healthcare M&As | Why Medicaid is 'ripe for innovation' | 8 Humana updates

March 23, 2023

• • Payers lobby against proposed MA rates | Empty CMS parking lot stirs questions | NC treasurer on a mission against payers, hospitals | Bright awards execs bonuses | Why tech talent is headed to Optum | Medi-Cal may soon pay for rent

March 22, 2023

• • DOJ drops UnitedHealth-Change appeal | Calif. lawmakers push for single-payer | Sen. Warren urges CVS-Oak Street FTC review | UnitedHealth puts Minn. HQ up for lease | Highmark posts '22 earnings | States ranked by Medicaid fraud dollars

March 21, 2023

• • Surprise billing determinations to resume | 150 top places to work in healthcare | Fallout over DC marketplace breach | States with best behavioral coverage under Medicaid | Miss. gov. vetoes prior authorization bill

March 20, 2023

• • 6 payer CEOs among 'world's most influential' | Fla. wants to make it harder to sue insurers | Are COOs becoming optional? | Oak Street: MA rate changes are bad for health equity | What payer execs are saying about novel therapeutics | 9 MA updates

March 17, 2023

• • The 'most engaged' payer workplaces | What Medicaid members are saying about redeterminations | Payers, providers push for No Surprises arbitration guidance | Centene loses out on Ind. managed-care contract | Meet Bright Health's leaders

March 16, 2023

• • Fla. takes over Bright's finances | CMS posts drug negotiation guidance | Prior auth is worsening patient outcomes, physicians say | Who gets to go by 'Dr.'? | Retirees push back on MA | 3 Medicaid expansion updates

March 15, 2023

• • UnitedHealth members appeal major coverage ruling | Google updates search engine for Medicaid unwinding | What 7 leaders said about CMS' proposed MA rates | Telehealth startups lean into weight loss drugs | 10 recent payer exec moves

March 14, 2023

• • The 'world's most ethical' health insurers | Fla. is 'ground zero' for payer fraud | Why an Oregon MCO bought a hotel | 20 hospitals with smallest CEO-worker pay gaps | UnitedHealth, Morehouse partner up

March 13, 2023

• • Weight loss drugs could increase Medicare rates: Report | Payers are evading price transparency rules, senators say | Optum Health names regional CEO | Insurtechs lost $2.3B in '22 | 8 UnitedHealth updates

March 10, 2023

• • Medicaid termination dates by state | Biden's $6.8T budget: 15 healthcare notes | CVS has 'premier' assets to support Medicare, CEO says | World's largest insurers by market cap | BCBS NC reports $36M profit in '22 | NYC greenlights Aetna MA plan

March 09, 2023

• • Calif. drops $54M Walgreens deal | Hundreds in Congress affected by ACA data breach | 8 prior auth. updates | AHIP leads coalition to support Medicaid unwinding | 8 MA study results | How many clinics does CVS, Optum have?

March 08, 2023

• • Payers, providers unite against CMS | Medicaid work rules floated in Congress | Moody's: Payers face weaker earnings in '23 | Cuban to sell 1st branded drug | CareFirst BCBS, Aledade partner | 18 recent CMS moves

March 07, 2023

• • 'We're done': Calif. cuts ties with Walgreens | Biden's plan to sustain Medicare | 5 payers reporting losses in '22 | Transcarent to partly acquire 98point6 | Where Humana has commercial members | 10 MA startups to know

March 06, 2023

• • Health system vs. payer profits in '22 | How Aetna leverages CVS to boost Medicaid outreach | Friday Health Plans to layoff 98 | Cigna's global strategy lead departs | Excellus BCBS profits fall 50% | 5 Apple healthcare job openings

March 03, 2023

• • Is Texas' gold card rule worth its weight? | NC reaches Medicaid expansion deal | Humana, Aledade partner on senior care | Oak Street posts $510M loss | States ranked by 2023 MA enrollment

March 02, 2023

• • Feds open another PBM probe | BCBS Mich. posts $777M loss in 2022 | Who spent $1M to disparage a hospital? | Viewpoint: MA audits don't go far enough | 22 US hospitals among Newsweek's 100 best in world | 20 things to know about SNPs

March 01, 2023

• • Biden to GOP: Don't touch federal insurance dollars | Bright Health's future in question | Apple wants to change physician, patient behaviors | MA margins far outpace other markets: Report | Cuban nets 2 million customers | CareSource, Walmart partner

February 28, 2023

• • MA members more likely to avoid hospitalization | BCBSA: Site-neutral Medicare payments could save nearly $500B | The 'reimbursement wars' keeping hospital execs up at night | What does Gen Z consider a high starting salary? | 15 exec moves in February

February 27, 2023

• • Surprise billing determinations to partly resume | Walmart Health adds executives | Humana's group exit shows allure of govt. markets | Inside Ark.'s Medicaid speed-run | Where Ozempic prescriptions are surging | MA declining in 3 states

February 24, 2023

• • 4 changes needed beyond price transparency | Payers ranked by '22 MA growth | 16 systems partnered with One Medical | Insurers lead latest CEO trend | Aetna preps for N.C. employee plan takeover | 6 payer market exits to note

February 23, 2023

• • Humana to exit employer group insurance business | MA enrollment tops 31M | Kaiser shifting 1,200 jobs out of HQ | Sens. continue 'junk' health plan fight | Feds close healthcare-sharing ministry

February 22, 2023

• • UnitedHealth buys LHC Group | Cigna blocks former exec from new CVS role | Amazon closes One Medical deal | MA growth slows | 6 million children could lose CHIP coverage during redeterminations | States ranked by HDHP use

February 21, 2023

• • 4 major prior auth changes proposed by CMS | Payers' role in the Ozempic shortage | Cuban to partner with independent pharmacies | The best US hospital, per ChatGPT | The secret to building a 5-star MA plan | 8 Elevance Health updates

February 20, 2023

• • Top 10 payers in 2023 | Most Medicaid members don't know about redeterminations | Payers, HHS spar over MA policies | Why Walgreens is shifting from pharmacies to physicians | Inside the new health equity strategy at BCBS Tenn. | 7 UnitedHealth updates

February 17, 2023

• • 3 'overpaid' payer CEOs | UnitedHealth-LHC deal closing looms | MA members need less healthcare savings: Report | 5 payers conducting layoffs | Lawmakers want MA reforms | Moderna promises $0 COVID vaccines | Optum hits 70k physicians

February 16, 2023

• • Cigna gets restraining order in CVS noncompete case | SelectHealth names CEO | 30+ payers among nation's best employers | Payers ranked by 2022 Medicaid membership | CommonSpirit posts $451M loss | Optum provides better care than FFS Medicare: Study

February 15, 2023

• • Payers with the most commercial members | Health system CIOs weigh in on CVS' Oak Street buy | 20% of payers hiring for Medicaid redeterminations | Meet the Cigna Group's exec team | Hospitals' looming Medicare cut | 8 recent payer exec moves

February 14, 2023

• • BCBS Minn. lays off 80 | Payers with the most MA members | Cuban's pharmacy may save US $1.2B: Study | UnitedHealth: Millennials have unprecedented utilization rates | 7 best 3rd-party payer tools in '23 | 10 Cigna updates

February 13, 2023

• • Cigna rebrands | Kaiser posts $4.5B loss | What payer execs are saying about MA audit changes | N.Y. debates single-payer bill | Insurance startup Sana begins layoffs | CMS pauses No Surprises Act payment determinations

February 10, 2023

• • HHS' roadmap out of the PHE | Payers ranked by 2022 profit | What payer leaders are saying about Medicaid redeterminations | Oscar posts $226M Q4 loss | Optum vs. CVS after Oak Street deal | Biggest deniers of ACA claims

February 09, 2023

• • Payers ranked by 2022 revenue | Can the 'Netflix' model of insurance work? | Tenet profit sinks | UnitedHealth launches monetary rewards | Centene to pay $215M in Calif. Medicaid settlement | Molina posts $56M Q4 profit

February 08, 2023

• • CVS, Oak Street strike $10.6B deal | State of the Union: 10 healthcare notes | Centene to lose 2.2M Medicaid members | 10 fastest-growing C-suite roles | UnitedHealthcare, Temple Health split over Medicaid | 15 things to know about MA star ratings

February 07, 2023

• • Payers lose surprise billing lawsuit | Centene posts $213M Q4 loss | CVS zeroes in on Oak Street Health | How payers are fighting provider burnout | Highmark reports phishing attack | The 'hard truth' about staff shortages

February 06, 2023

• • Google's stop-loss insurance unit growing quickly | CVS names DEI chief | Feds prepping One Medical antitrust case: Report | More scrutiny for providers after MA audit rule | States ranked by dual-eligible population | 6 SDOH updates

February 03, 2023

• • Cigna posts $1.2B Q4 profit | CMS floats universal quality measures | Payers with most MA prior auth denials | Amazon, Optum, CVS Health: Who will be 2023's biggest disruptor? | 29 burned out specialties, ranked | 9 prior auth updates

February 02, 2023

• • More layoffs at Bright Health | CMS signals MA 2024 payment bump | 6 most admired payers | Humana considering all options with new MA audit rule | TMA files 4th No Surprises Act lawsuit | Will payers recoup payments for fake nursing?

February 01, 2023

• • Humana posts $15M Q4 loss | Centene to pay $66M in Indiana Medicaid settlement | How states are prepping for Medicaid unwinding | FTC unlikely to stop UnitedHealth-LHC deal | 7 reactions to CMS' new MA audit rule | 23 exec moves in Jan.

January 31, 2023

• • Payers facing $4.7B MA clawback | PHE to end May 11 | CMS creating special ACA enrollment period | BCBS Ore. president to lead Kaiser region | Blue Shield Calif. launches virtual-first plan | 7 Elevance updates

January 30, 2023

• • The future of MA, as AHIP's president sees it | What's next for payers' pricing data? | Hospitals' worst year since COVID | Most disenrolled from Medicaid find coverage within a year | Can Calif. deliver on Medi-Cal reform? | 8 UnitedHealth updates

January 27, 2023

• • States eye prior auth reforms | Cigna sues exec headed to CVS | FTC still probing UnitedHealth-LHC deal | Expect more Optum-hospital deals this year | Payers ranked by employee wages | Calif. inmates to get Medicaid | 5 new payer partnerships

January 26, 2023

• • The PBMs that defied Mark Cuban's doubts | UnitedHealth invests in Appalachia | Cleveland Clinic rarely bills for MyChart | Elevance to add $4.5B revenue with La. buy | Payers with best work-life balance | ACA enrollment at record 16.3M

January 25, 2023

• • Elevance posts $949M Q4 profit | Payers facing the largest MA clawbacks | BCBS plans push for site-neutral payments | Blue Shield Calif. lays off 373 | Boston Med CEO to lead Mass. HHS | AI could save payers billions: McKinsey | 7 Optum updates

January 24, 2023

• • Insurtechs face uncertainty in 2023 | Elevance to buy BCBS La. | FCC OKs Medicaid robocalls | CVS refreshes executive team | Amazon launches Prime for prescriptions | AHIP's 2023 State of the Industry: 7 notes

January 23, 2023

• • MA scrutiny intensifies in 2023 | Lawmakers go after UPMC | Woman shoots, kills husband in Fla. hospital | NC rejects BCBS, UnitedHealth appeals of state health plan award | McKinsey's payer predictions through 2026 | 9 payer workforce moves

January 20, 2023

• • Optum, CVS, Walgreens: Inside the primary care battle | UnitedHealth's new behavioral benefits | BCBS Minn. cuts ties with Amerigroup | 10 systems with strong finances | It's time to end 'magical thinking' in healthcare

January 19, 2023

• • The largest physician employer in America | Hospital access meltdown persists in Calif. | Q&A with Point32Health CEO | Trinity leans into virtual nurses | Best healthcare workplaces in 2023 | 10 MA updates

January 18, 2023

• • MA enrollment hits 30M | Express Scripts names new president | ACO REACH expanding in 2023 | Cleveland Clinic expects $200M loss | Healthgrades' 50 top hospitals | UnitedHealth named world's largest insurer

January 17, 2023

• • 16 exec moves in 2023 | Optum eyes big value-based care boost | Calif. sues major PBMs | No big 'tripledemic' effect on costs, UnitedHealth says | 100 largest hospitals, systems in US | Jefferson to trim exec jobs | 6 Cigna updates

January 13, 2023

• • UnitedHealth posts $4.9B Q4 profit | 10 cities with worst inflation | BCBS appeals new NC benefits contract | CVS 'disappointed' in MA enrollment | Ill. fines Quartz for mental parity violations | Viewpoint: Optum won't fix hospital finances

January 12, 2023

• • PHE extended for 12th time | Cuban's pharmacy teams up with 3rd PBM | CMS' new Medicare drug negotiation timeline | 56 best healthcare jobs | ACA enrollment up 13% | UnitedHealthcare names president of individual, family plans

January 11, 2023

• • CMS' Medicaid redetermination strategy | Vanderbilt dropping MA plans | MyChart messages decrease when hospitals bill for them | Ky. system sending 500 employees to Optum | BCBS Michigan beats 'Blues Conspiracy' | 50 things to know about MA

January 10, 2023

• • UnitedHealth Group names chief innovation officer | Healthcare at its worst: 10 Shkreli awardees | CVS eyeing Oak Street Health purchase | Facilities where most 'No Surprises' disputes happen | Humana boosts MA outlook

January 09, 2023

• • Rite Aid names former Humana exec interim CEO | Payers with the most remote jobs | BCBS Texas, Ascension could split | Capital Blue Cross ordered to repay denied claims | Why NC chose Aetna over BCBS | 3 HCA execs resign

January 06, 2023

• • VillageMD closes Summit Health deal | Maine system sends 1,400 employees to Optum | Highmark names insurance president | States where most 'No Surprises' disputes happen | 5 reactions to Medi-Cal contract shuffle

January 05, 2023

• • Humana laying off 1,100+ | CPT codes behind most 'No Surprises' disputes | Aetna snags N.C. state contract from BCBS | Lawsuit between UnitedHealth, former execs closes quietly | BCBS companies form drug contracting group

January 04, 2023

• • Should Elon Musk buy Oscar, Bright Health? | Payers, providers that see the most out-of-network disputes | Within days, hospital access crumbles in Calif. | Centene boosts outlook after Medi-Cal contract reversal | Ga. launches insurance portal

January 03, 2023

• • Calif. awards more Medicaid contracts | UnitedHealthcare names regional CEO | CMS cracks down on MA TV ads | 16 payer exec moves in Dec. | BCBS Tenn., Methodist Le Bonheur split | Former Apple CEO joins MA plan | Amazon inches closer to One Medical buy

December 29, 2022

• • Bright Health's challenges continue to mount | 50 drugs with biggest price cuts from Mark Cuban's pharmacy | N.C. could be model for Medicaid redeterminations | TikTok video prompts N.Y. hospital probe | 4 payers among best IT workplaces

December 28, 2022

• • States' public plans aren't working | Dr. Sachin Jain on the future of MA | ACA coverage hits 11.5M | Nurses confront hospital president over paid leave | 20 recent CMS moves | Medicare Part B premiums, deductibles set to fall: 7 things to know

December 27, 2022

• • 8 prior auth updates in 2022 | Why Springfield Clinic launched its own health plan | Lawsuit: Former Centene execs defrauded Medicaid | 52% think PHE still needed | Humana, TriWest tapped for $136B Tricare contracts

December 22, 2022

• • Top 10 payer stories of 2022 | 13 states with decreasing premiums | Medicaid directors support federal redetermination plan | How prior auth reform succeeded in Mich. | Hospitals with the most ER visits | Elevance Health sells 30-acre Va. campus

December 21, 2022

• • States push for PHE's end | Americans want more price transparency laws | Payers should withstand inflation: Fitch | Can hospitals compete with CVS, Walgreens? | UnitedHealth Group's 2022 in 10 headlines | Top-rated commercial plans nationwide

December 20, 2022

• • Centene spent $307M on overbilling settlements in 2022 | $1.7 trillion omnibus bill: 8 healthcare takeaways | Medicaid eligibility reevaluations could start in April | Elevance sells $76M campus | Calif. system could split from 3 big payers

December 19, 2022

• • New price transparency rules take effect Jan. 1 | BCBS Miss., UMMC end contract dispute | Centene projects $137M in '23 revenues | Mayo billing draws scrutiny | BCBS Mass. adds health equity to provider contracts | 6 Optum provider purchases

December 16, 2022

• • 4 stats show enormity of price transparency data | Centene to pay $44M in Iowa Medicaid settlement | Surge of CEO exits may signal more to come | The physician who toppled a $32B crypto giant | 10 value-based partnerships to know

December 15, 2022

• • CMS proposes new MA marketing, prior auth rule | Centene shakes up C-suite | SCAN Group, CareOregon to merge | Healthcare spending hit $4.3 trillion in '21: 7 notes | Tracking MA dollars is top priority, CMS official says | 9 UnitedHealth Group updates

December 14, 2022

• • CMS floats rule for ACA plans: 5 notes | Cigna, ProMedica at odds | BCBS Mich. inks full-risk contracts | 12 cities hit hardest by inflation | 5 hospitals scaling back care | How some MA plans dodge audits

December 13, 2022

• • 34 payer CEO moves | Bright Health risks NYSE delisting | 12 hospitals cutting jobs | HHS points hospitals to flexibilities for flu, RSV | Cigna, Fla. hospital to cut ties | Optum execs join board for Walmart heir's med school

December 12, 2022

• • It's time to end PHE: Bloomberg | No Surprises Act's 1st year: 6 updates | Musk's 'prosecute Fauci' tweet draws swift backlash | Unions sue Elevance over claims data access | 4 insurance layoffs in 2022 | 23 best-managed healthcare cos., per Drucker

December 09, 2022

• • Health systems that won't charge for MyChart messages | How payers streamline prior auth | Employee health benefits costs to rise 5.4% in 2023 | Hospitals may be unknowingly sharing data with Elon Musk | 200,000 Kaiser Hawaii members can now choose BCBS

December 08, 2022

• • MyChart message fees live on unstable ground | UnitedHealth's LHC Group buy delayed | Mark Cuban Cost Plus partners with 2nd PBM | 4 reactions to CMS' prior auth pitch | Most competitive commercial markets | 7 payer leaders on 2022 equity efforts

December 07, 2022

• • CMS pitches prior auth reform | 50 states ranked by health | Payers cut ties with Texas home health firm after CEO indicted | 9 MA plans audited for upcoding by HHS | Centene to pay $17M in Ore. Medicaid settlement | Flu activity by state

December 06, 2022

• • Medicaid may drop 18 million when PHE ends | Why CMS vaccine mandate is no sure thing | UnitedHealth Group CEO outlines growth strategy | Advocate Health names leadership team | Centene invests $8M in Uvalde health center | 10 highest-paid payer CEOs

December 05, 2022

• • Optum projects $214B in '23 revenues | The ins and outs of charges for MyChart messages | UH suspends staff tied to capitol attack | UnitedHealth puts $3M behind nurses | Why 7 payers added new exec roles | Humana boosts MA outlook by 100K

December 02, 2022

• • UnitedHealthcare projects $276B in '23 revenues | Atrium, Advocate Aurora complete merger | No Surprises Act disputes hit 'logjam' | Fired MetroHealth CEO paid himself for SDOH work | Blue Shield Calif. laying off 300+ | Most competitive MA markets

December 01, 2022

• • UnitedHealthcare loses to TeamHealth again | 3 reasons payers end gold-card programs | Highmark reports $600M in insurance gains | Regence, Optum-owned Everett Clinic at impasse | Fla. Medicaid admin. departs | Where 11 payers are exiting markets

November 30, 2022

• • Rising utilization rates may spell trouble for payers | Humana plans Fla. layoffs | 25 payer exec moves in Nov. | Insurers building IT talent pipelines | UnitedHealthcare, NM system at contract impasse | 3 things hindering alternative payments

November 29, 2022

• • UnitedHealth projects $360B in '23 revenues | Fla. hospital CEO killed in murder-suicide | Calif. hospital files for bankruptcy after Anthem fight | More systems charging for MyChart messages | Least competitive MA markets | 9 payer-provider disputes

November 28, 2022

• • Top 5 barriers to automated prior auth | UnitedHealthcare, Providence reach deal | Mark Cuban in talks with hospitals to solve drug shortages | New ACA customers up 40% | Fla. hospital CEO resigns after arrest | 10 providers seeking payer talent

November 25, 2022

• • Payers are mixed on gold cards | Fired MetroHealth CEO says board retaliated | Kaiser reports EHR data breach | Where 8 payers are investing | MA premiums rise slightly in 2023 | 5 major Centene deals this year | 14 UnitedHealthcare updates

November 23, 2022

• • Payers decry state prior auth laws | Sanders poised to lead Senate health committee | Bright Health awards C-suite bonuses amid layoffs | Medicaid directors urge PHE clarity | MetroHealth CEO fired over unreported bonuses | 15 MA updates

November 22, 2022

• • Anthem backlash on TikTok grows louder | Largest exchange payers in every state | States ask CMS to scrap vaccine rule | Pharma giants ditch Twitter | Mark Cuban Cost Plus Drugs nears 1k generics | 5 startups payers are investing in

November 21, 2022

• • DOJ to appeal ruling on UnitedHealth-Change deal | MA audits reveal overbilled members | Biden: ACA enrollment up 40% | Walmart loses top health exec | No Surprises Act protects 9M patients | 20 payer CEO moves | 11 Elevance Health headlines

November 18, 2022

• • Mark Cuban's next healthcare goals | Centene selling Magellan Specialty Health | UnitedHealth, WakeMed ink contract | Which hospitals got F's from Leapfrog | Security Health Plan nabs Johns Hopkins exec | Payers ranked by MA transportation benefits

November 17, 2022

• • Optum hiring laid-off tech talent | Medicaid confusion as payers prep for end of PHE | Cleveland Clinic to bill for MyChart messages | Is Epic's dominance good for healthcare? | Leapfrog's straight-'A' hospitals

November 16, 2022

• • Anthem scraps $40K bill after patient's TikTok | Providence losses top $1B in 2022 | Counties with most MA plans | 6 payer execs headed to startups | Senate Dems want more MA rules | BCBS Ill. faces class action over denied transgender care

November 15, 2022

• • Payer-provider fights get messier | Amazon Clinic debuts | 19 payer exec moves | Record number of MA plans available in 2023 | Aetna's govt. business CFO departs | Google partners with Highmark, Mayo on data projects | 6 recent M&A deals

November 14, 2022

• • HHS to extend COVID PHE past Jan. | Eli Lilly loses billions after fake insulin tweet | 6 recent UnitedHealth M&A deals | CVS strategy chief departs | Aetna, Crossover Health launch value-based primary care pilot | 10 health systems with strong finances

November 11, 2022

• • 8 prior authorization updates | Aetna, Lehigh Valley Health to cut ties | DeSantis taps Broward CEO for transition | Amazon Pharmacy nabs payer contracts | Why BCBS Tenn. ranks among best places to work | 9 payer virtual care moves

November 10, 2022

• • Bright Health preps for layoffs | Leaked Amazon video shows new telehealth service | Elevance to buy BioPlus specialty pharmacy | Cigna invests in VillageMD-Summit deal | Oscar posts $194M Q3 loss | Humana execs are ditching Louisville

November 09, 2022

• • Payers ranked by Q3 profits | UnitedHealth could close on LHC deal in Dec. | SD to expand Medicaid | NC hospital's Medicare contract again at risk | Largest MA payers by state | Q&A: Elevance's 1st health equity chief

November 08, 2022

• • Pa. inks prior auth reform law | What payer CEOs said about MA in Q3 | Jefferson exec to lead Highmark market | Texas asks Friday Health Plans to leave marketplace | How Kaiser built high-quality health plans | Is MA fraudulent? 7 expert thoughts

November 07, 2022

• • Kaiser posts $1.5B Q3 loss | 'Do you not see this as an arms race?' Cigna CEO questioned on M&A | VillageMD buys Summit Health for $8.9B | 'Difficult decisions' loom for hospitals | UnitedHealthcare holds 28% of MA market | CVS expecting $2B revenue hit

November 04, 2022

• • 3 states take on prior auth reform | Big payer profits recall 'the house always wins' | Cigna spending $200M on Centene PBM deal | Senate panel pushes more MA marketing rules | L.A. Care Health Plan nabs Oscar CMO | States with least competitive markets

November 03, 2022

• • Cigna's 70% boost in profits | What we've learned from payer price data | Payer, hospital relations are worsening | 26 payers entering, exiting markets | Medicare members aren't switching plans | The most-liked insurers in 2022 | 8 Centene headlines

November 02, 2022

• • CMS' 4 final payment rules: 15 takeaways | CVS chalks up Q3 loss to $5B opioid settlement | Humana's $1.2B Q3 | ACA call center workers strike | 2,273 hospitals dinged for readmissions | BCBS Mass., Caremark partner | 10 providers seeking payer talent

November 01, 2022

• • 25 payer exec moves | ACA open enrollment begins: 6 key changes | JPMorgan's new healthcare venture team | UnitedHealth, Broward strike deal | Health systems zero in on C-suites | Miss. orders payer to shut down | Aetna, Amedisys partner on MA

October 31, 2022

• • CMS adds Medicare special enrollment periods | Hospital finances set for worst year in decades | Why states are blocking Medicaid home monitoring | Anthem BCBS, Aspirus Health hit contract impasse | How Centene plans to boost MA star ratings

October 28, 2022

• • CMS cracks down on MA TV ads | DC official who took Elevance job fired | Optum denies settling with Ohio | UnitedHealthcare expands ACA plans to 22 states | Aetna, Waymark partner in Va. | 14 fastest growing healthcare cos. | 15 MA headlines

October 27, 2022

• • Pa. lawmakers pass prior auth reform bill | Molina's Q3 profits jump 61% | CareFirst, Johns Hopkins ink contract | UnitedHealthcare, Apple extend fitness partnership | Kaiser Permanente's telehealth plans | Elevance expands post-acute program to 15 states

October 26, 2022

• • Walmart Health expands in Fla. | UnitedHealth sells $9B in bonds for Change purchase | CMS seeks input on ending PHE | OptumRx settles Ohio overbilling claim for $15M | Apple Fitness free for Aetna MA members | Fla. Blue adds Amazon Pharmacy

October 25, 2022

• • Humana exiting Colo. group market | Centene posts Q3 profits, names PBM partner | States with most 5-star MA plans | 35 state AGs want PBM regulation | Okla. hospital ends MA contracts | Lawmakers press CareFirst, Johns Hopkins over contract dispute

October 24, 2022

• • Elevance now largest commercial payer, CEO says | 'Money on the table': Study finds negotiated payer prices vary widely | JPMorgan opens primary care centers | Most-liked payer in each region | Fla. Blue, Sanitas partner on primary care | 13 MA updates

October 21, 2022

• • Insurers prep for great 2023 coverage shuffle | CMS unveils 340B pay plan | Pfizer eyes $110 COVID shot price tag | 20 top hospitals' payer mix | Providence Health Plan's CEO on building a plan everyone wants

October 20, 2022

• • UnitedHealthcare names Calif. CEO | DOJ wants info on CVS' Signify buy | AMA, AHA challenge surprise billing arbitration, again | Centene jumps into Ga. politics | CareFirst loses DC Medicaid bid | Where 5 payers are reforming prior authorization

October 19, 2022

• • Mark Cuban's pharmacy, Vivio partner on specialty drugs | Elevance's $1.6B Q3 | UnitedHealth, Duke spar over Medicaid contract | The largest PBM in each state | UnitedHealth Group expands behavioral network 25% | 12 payer partnerships

October 18, 2022

• • Apple to take up health insurance | The rise + fall of COVID billionaires | DOJ sues Cigna for alleged MA fraud | For payers, addition by COVID subtraction | Updates on Medicaid shakeup in Calif. | The largest payer in each state

October 17, 2022

• • UnitedHealth spending $100M on Change integration | Bill would ban 'Advantage' from Medicare | Optum, UCLA partner on AI | Walmart to sell OTC hearing aids | Best MA plans of 2022 | 14 payers entering, exiting markets

October 14, 2022

• • UnitedHealth's $5.3B Q3 | COVID emergency renewed amid mixed signals | CMS to release MA audits after lawsuit | Valley Health sues Anthem Va. over provider rates | Bright Health's insurance exit effects Colo. reforms | CMS extends bundled payment pilot

October 13, 2022

• • CommonSpirit confirms ransomware hit | Bright Health's troubled 2022 | How big payers fared in CMS' MA star ratings | BCBS boosting federal employee benefits | Va. building its own insurance exchange | Meet the BCBS CEO in every state | 11 Aetna headlines

October 12, 2022

• • ACA family glitch fix finalized | How payers have exploited MA | Home Depot appeals $2.7B BCBS settlement | BCBS Miss., UMMC end talks | CommonSpirit's big IT problems | Why MA star ratings went down | Morgan Health seeks commercial insurance researcher

October 11, 2022

• • Bright Health ends individual, group business | Blue Shield Calif. sues state over Medi-Cal contracts | CMS' 5-star MA plans | CVS in exclusive talks to buy Cano | TPG Capital buys ClaimsXten for $2.2B | Priority Health, Kroger launch Medicare plan

October 07, 2022

• • Avg. MA star rating falls | Payers send members to Mark Cuban's pharmacy | Optum's ownership of Kelsey-Seybold: 5 notes | Elevance facing MA fraud suit from DOJ | OIG: BCBS Tenn., Inter Valley owe millions in overpayments | Meet the BCBS CEOs in the West

October 06, 2022

• • Kaiser's chief digital officer heads to Target | COVID testing lawsuit against Aetna dismissed | J.D. Power ranks payers' telehealth services | Aetna, Emcara partner on Fla. Medicaid | 7 recent M&A deals | 7 payers earn NCQA health equity accreditation

October 05, 2022

• • CMS: MA premiums to decrease | Judge revives antitrust lawsuit against BCBS Mich. | CVS to sell Bswift platform | HCSC names Medicaid president | 3 payer CEOs among most powerful women, per Forbes | Where 3 payers are expanding behavioral networks

October 04, 2022

• • Optum, Change finalize $7.8B merger | BCBS Texas, Southwestern Health ink contract | 8 MA expansions in 2023 | 7 payers join hurricane relief efforts | Q&A: Clover's Health's new CEO | BCBS Mich. selling Advantasure | 13 best Medicaid plans

September 30, 2022

• • 20 executive changes at insurers | 29-hospital system wants $900M more from BCBS Texas | CBO backs hospital price caps | SC hospitals brace for Ian | Counties with most medical debt | Providence CEO questioned on billing | 9 new payer-provider contracts

September 29, 2022

• • Payers respond to Hurricane Ian | Florida Blue, BayCare resolve dispute | Texas physician 'gold card' rules to take effect | Centene to pay $14M in Mass. Medicaid settlement | PBM probe is 'top priority' at FTC | 8 payer partnerships

September 28, 2022

• • Humana, CVS fight for Cano Health | Independence Blue Cross, Penn Med. to co-own Tandigm | Where payers are investing | Medicare Part B premiums, deductibles to go down in 2023 | AHIP: Medicare spending is 7% higher than MA | Horizon NJ to restructure

September 27, 2022

• • What Optum gets in Change deal | CMS faces another lawsuit over surprise billing rule | BayCare pauses elective care for Florida Blue members amid dispute | Neb. picks 3 payers for Medicaid contracts | 6 insurance startups to know

September 23, 2022

• • Humana looking to buy Cano Health | UnitedHealth, Peloton expand partnership | Payers ranked by MA growth | Aetna cancels senior transport contract | When Inflation Reduction Act Medicare changes take effect | Meet the BCBS CEOs in the South

September 22, 2022

• • Aetna deems Aduhelm medically necessary | Uninsured, publicly insured more likely to report negative care experience | BCBS Texas, Amarillo health system to cut ties | McKinsey: MA star ratings to decline in 2023 | Where Medicaid acceptance is greatest

September 21, 2022

• • 'Already a 3-headed dragon': Medical groups on UnitedHealth-Change | Optum names chief digital officer | AMA, AHA dropping No Surprises Act suit | BCBS, Texas Health Resources contract to end | Google adds Medicaid search filters

September 20, 2022

• • Judge clears UnitedHealth-Change deal | Best commercial plans in each state | Centene to pay $166M in Texas Medicaid settlement | Humana looks to recover MA growth | Former UnitedHealthcare CEO heads to JenCare | 8 payers entering markets

September 16, 2022

• • UnitedHealth beats facility fee lawsuit | DOJ charges 9 for prostitution billed to health plan | Hospitals' most financially difficult year | Best health plans of 2022, per NCQA | States ranked by uninsured residents | 10 exec moves

September 15, 2022

• • HHS set for 11th renewal of COVID PHE | House passes MA prior auth. reform | Q&A: UCare CEO | BCBS NC's value-based programs have saved $500M | Record uninsured rate to fall further | States ranked by Medicare telehealth use | 10 virtual care moves

September 14, 2022

• • No Surprises Act may surge ER visits | Oregon weighs single-payer | Optum's Minn. campus up for grabs | Where Medicare acceptance is greatest | HCSC expands virtual care to Ill., Texas | People in cities use telehealth most, OIG finds

September 13, 2022

• • UnitedHealthcare, Envision feud over payments in court | CarePoint accuses competitors of trying to 'destroy' hospitals | Noncitizens can use Medicaid, CHIP: DHS | AMA joins class action against Cigna | BCBS Tenn. goes permanently remote

September 09, 2022

• • Amazon wants payer talent | Judge questions DOJ in UnitedHealth, Change challenge | What Aetna gains from Signify | CareFirst, Johns Hopkins near breakup | Highmark's VBC programs are saving billions | 4 terminated payer contracts

September 08, 2022

• • Judge gives partial win to ACA opponents | Long COVID is a major employer healthcare cost | Health systems' digital investment picks | Payers are ditching offices nationwide | Aetna expands ACA plans in 10 states | 13 payers entering, exiting markets

September 07, 2022

• • Payers ranked by CEO-to-worker pay ratio | UnitedHealth, Walmart partner on MA | Where every insurance premium dollar goes | Mark Cuban's Cost Plus nears 1M customers | UnitedHealthcare launches ACA plans in 4 states | WellCare Ky. names 2 execs

September 06, 2022

• • CVS' $8B Signify buy: 6 notes | Payers' prices have emerged. How useful is that? | FTC probes Amazon-One Medical deal | Centene names chief ethics exec | CMS tightens rules on celebrity MA ads | 10 newly inked payer contracts | MetroPlus opens NYC HQ

September 02, 2022

• • Aetna, Covenant cut ties | Humana completes CenterWell rebrand | Trinity, CommonSpirit finish deal | Free COVID shots will run out in Jan. | Blue Shield Calif. names COO, CFO | 6 payers fined by states | Iowa awards Medicaid contracts

September 01, 2022

• • CMS looks to streamline Medicaid, CHIP enrollment | Health systems shrink exec teams | 41 exec moves in August | MA enrollment is lowest in these states, but that's changing | Providence HP names CIO | La. picks Magellan for Medicaid PBM

August 31, 2022

• • 'Vomit at your insurance companies, folks': Anthem denial video goes viral | Highmark's $174M losses in 2022 | Oscar, Health First cancel deal | Cigna's first chief health exec | BCBS Mass. names CEO | 7 payer workforce moves | 6 UnitedHealth stories

August 30, 2022

• • Centene, Tenet hit contract impasse | Bright Health on brink of insolvency | 3 payers tapped for Medi-Cal contracts | Former NBA player pleads guilty to $5M fraud scheme | Cigna enters ACA market in 3 states | 6 payers selling assets

August 26, 2022

• • What do healthcare execs really expect from Amazon? | UnitedHealthcare, Humana dominate MA market | Best health systems to work for, state by state | BayCare, Florida Blue spar over contract | RN charged with murder worked as travel nurse until arrest

August 25, 2022

• • UnitedHealth CFO faces lawsuit over 401(k) | The end of Amazon Care | Why such high CEO pay at Clover, Oscar + Bright Health? | UPMC operating income sinks 86% | Centene to pay $32M to settle Medicaid fraud claims | Largest payers, state by state

August 24, 2022

• • Health plan, providers pay $71M to settle billing fraud claims | Nurse charged with murder in patient death | Medicare Advantage marketing tactics under investigation | States ranked by life expectancy | 8 health systems with strong finances

August 23, 2022

• • 10 top-paid CEOs of publicly traded payers | No Surprises Act final rule: 3 takeaways | Whitmer orders payers to lower rates | 10 best, worst states to retire | CMS floats mandatory Medicaid, CHIP quality reporting

August 19, 2022

• • Centene nixes $1B HQ plan | US down to last mos. of free COVID vaccines | Empire BCBS, Northwell ink contract | MA plans ranked by customer satisfaction | Mass. overhauls prior auth. | Sentara Health Plans names president

August 18, 2022

• • Kaiser plans $1.7B expansion | Anthem, MaineHealth end monthslong, $70M dispute | Inflation Reduction Act may curb Medicaid losses when PHE ends: Fitch | Calif. fines payer $2M for illegal drug moves | Wis. county to vote on 'nationalized' insurance

August 17, 2022

• • Democrats' $739B bill is now law: 7 healthcare notes | UnitedHealth under fire for productivity monitoring | Industry trends to watch, per 300 payer execs | CareFirst names chief of staff | OU Health, UnitedHealthcare ink contract | 9 Centene stories

August 16, 2022

• • 10 Qs with Aetna's top physician | Providence posts $934M loss | UnitedHealth buys Texas insurer | Fla. bans transgender Medicaid coverage | Humana to buy Wis. managed care group | Top Aetna exec named CEO of home care firm | 6 recent M&A deals

August 12, 2022

• • Humana completes $2.8B deal | 7 payers respond to monkeypox | Oscar's big growth + pause on outside deals | Payer booted from Wash. | CVS names SVP of retail health | HCSC to purchase Trustmark Health Benefits | GoHealth lays off 800

August 11, 2022

• • CVS said to have bid for One Medical weeks before Amazon | CMS blocks Ga.'s new ACA plan | Bright Health sees $432M loss in 6 mos. | 4 payer groups on Inflation Reduction Act | Payer economic trends: Moody's | Allscripts seeks payer M&A

August 10, 2022

• • BCBS clears $2.7B antitrust settlement | Kaiser posts $1.3B loss | Duke LifePoint hospital retains Medicare funding after patient deaths | 11 payers enter, exit markets | Centivo nabs top UnitedHealth attorney | Alignment's rapid growth: 10 notes

August 09, 2022

• • CVS to bid for Signify Health | 7 healthcare notes out of Democrats' massive $739B bill | Payers ranked by Q2 profits | Payers' behavioral health networks in 2022: AHIP | Clover Health names CEO | Ill. raises Medicaid rates for abortion providers

August 05, 2022

• • Change data 'could' help UnitedHealth, former CEO says | Payers ranked by Q2 revenue | CVS eyes primary care | How 3 payers use digital health platforms | Nationwide launching supplemental plan | Ochsner Health plan names CEO

August 04, 2022

• • Cigna's $1.6B Q2 profit | Elevance, Aledade partner up | Hospitals that treat most Black patients paid less | Idaho system launching health plan | Blue Health Intelligence names CEO | BCBS Tenn. starts IT institute | 8 recent Humana moves

August 03, 2022

• • CVS Health's strong Q2 | Uninsured rate hits new low | Dozens of payers affected by data breach | CommonSpirit welcomes CEO | Part D premiums down 2% in 2023: CMS | Centene chair stepping down | HCSC expands MA plans | 8 recent payer-provider contracts

August 02, 2022

• • DOJ v. UnitedHealth, Change trial: 8 notes | CMS' final inpatient payment rule: 6 takeaways | Molina sheds office space | Centene expects lower MA star ratings | 27 payer exec moves | BCBS v. UMMC: a timeline

July 29, 2022

• • BCBS Miss. sues UMMC execs amid contract break | Molina's 34% Q2 profit boost | 429 hospitals with 5 stars from CMS | Viewpoint: MA 3rd-party marketing rule misses the mark | UnitedHealth, Anthem execs join vision startup | Highmark, Bridges ink contract

July 28, 2022

• • Humana to restructure execs, units | 192 new 1-star hospitals | Trillions of rows of public payer data: When will it be usable? | Senator dares insurers to follow UnitedHealthcare's lead with insulin | UMMC broke law in BCBS dispute, state says

July 27, 2022

• • Humana boosts Q2 profits | Calif. payers commit to new primary care model | Optum vs. Amazon after $3.9B One Medical deal | 13 payer entrants, exits | The time to modernize data collection is now | States ranked by MA members

July 26, 2022

• • Trial begins for ACA preventive care rule | Mich. orders payer to stop operations | Centene posts $172M in Q2 losses | US News: 20 best hospitals | Centene selling European businesses | BCBS Neb. returns to ACA | Evernorth moves into NJ campus

July 22, 2022

• • Optum sees 7th exec exit | CMS releases home care quality measures | The state of MA in 2022 | 14 CEO moves | UnitedHealth forms Wis. ACO | 6 payers adding new C-suite roles | 5 states expanding Medicaid to noncitizens | Empire exits NYC MA plan

July 21, 2022

• • Payers raising rates 10% in 2023 | Q&A: BCBS Minn. CEO Dana Erickson | Amazon inks $3.9B One Medical deal | Elevance to grow post-acute program | AllWays to become Mass General Brigham Health Plan | Health Insurance Innovations, CEO settle SEC fraud case

July 20, 2022

• • Elevance Health's 8% Q2 profit dip | JPMorgan invests $30M in Centivo | Optum bets on virtual, home care | AIDS Health Foundation sues Express Scripts | Canopy, Providence take aim at Kaiser | Maine's ACA merger OK'd | 8 recent Centene stories

July 19, 2022

• • Calif. OKs Kaiser Medicaid contract | Q&A with PopHealthCare CEO Eric Galvin | OU, BCBS Okla. ink value-based contract | Clover Health expanding MA plans | WVU Med. creating Medicare, Medicaid plans | Humana becomes Pa. ACO partner | 9 MA headlines

July 15, 2022

• • UnitedHealth's Q2 profit: $5.1B | Empire BCBS to cover multiorgan transplant | Point32Health adds abortion travel benefit | Ill. physician charged in $4M BCBS, Medicare fraud scheme | Central Maine, Anthem ink contract | Molina to buy Wis. Medicaid MCO

July 14, 2022

• • Cleveland Clinic asks NY to review BCBS denial | Conviction in $600M fraud scheme | Centene sells Pantherx | Payer veteran joins AI firm | Underwriting earnings down 65% in '21 | Viewpoint: Defending PBMs

July 13, 2022

• • Northside, Anthem ink contract | Payment for childbirth by state | The nat'l crisis payers can help solve | Fla. seeks bids on $3.1B employee plan | Bind is now Surest | 7 legal actions against payers

July 12, 2022

• • How to start a PBM, Mark Cuban style | Burger King poaches Optum exec | Optum, Healthgrades parent form JV | UNC hospital's Medicare contract at risk | 9 payer market moves | Check-up on Highmark, Google's partnership

July 08, 2022

• • FTC wants more info on LHC, UnitedHealth deal | CMS floats physician pay rule: 7 notes | Pharmacies urge FTC to block PBM deal | Biden to issue EO on abortion access | Humana exec joins BrightSpring | 5 newly inked payer-provider contracts

July 07, 2022

• • Alec Baldwin nudges BCBS to cover surgery | Senate Dems push Medicare drug negotiation plan | Magellan names CEO | Why CMS wants to hide hospital safety data | 6 payer office moves | NH expands Medicaid dental with Centene settlement | 8 Cigna stories

July 06, 2022

• • CEO of BCBS of SC retires | 5 execs leave Optum | The drivers of 2023 premium changes | Payers want to expand MA despite scrutiny | 18% of ACA claims are denied: Study | Chubb acquires certain Cigna assets for $5.4B

July 05, 2022

• • A caveat to insurers' posted prices | NorthShore treats parade shooting victims | Which payers are covering employees' abortion travel? | What federal actions against PBMs could mean | CMS' new Rural Emergency Hospital designation

July 01, 2022

• • Payers' price transparency rule begins today | 25 exec moves in June | Top 15 systems, per Fortune/IBM | Hospitals grapple with Roe ruling | 74 nonprofit payers launch SDOH center | Calif. bill targets prior auth. | HCSC names top diversity exec

June 30, 2022

• • Crack down on MA plans, watchdogs urge Congress | Police kill armed patient in Baylor Scott & White ER | UnitedHealth's legal exec departs | Healthcare M&A dips 9% | Calif. to offer Medicaid to all undocumented immigrants

June 29, 2022

• • Meet Elevance Health's C-suite | AHA wants 340B funds now | Molina fined $1M for slow payments | Mich. hospital preps for layoff | Humana embraces hybrid work | Alignment expands to Texas, Fla. | 10 recent legal actions with payers

June 28, 2022

• • Anthem now Elevance Health | 9 payer voices on Roe v. Wade overturn | 'Let's get this done,' Mark Cuban tells Biden on drug savings | CMS' new cancer payment model | Former hospital exec convicted in $1.4B scheme | UnitedHealthcare, Wellstar ink contract

June 24, 2022

• • Supreme Court backs HHS on DSH payment rule | Colo. to launch health plan | SC payers can now deny care at odds with beliefs | 8 payer execs headed to startups | Audit: Ore. payers breaking health coverage law | Walmart expands doula coverage

June 23, 2022

• • LHC shareholders opt for sale to Optum | Mayo, UnitedHealthcare reach agreement | Calif. revokes payer's Medicare license | Hospitals see ongoing weaponization of COVID aid | Q&A with Banner|Aetna CEO Tom Grote | CMS urges ACA subsidies extension

June 22, 2022

• • Molina inks $4.6M false claims settlement | Optum sets out to curb lab tests | Supreme Court denies UnitedHealth appeal | Stop-loss COVID claims skyrocket 354% | 25 healthiest places in US | Centene exec now CEO of US Acute Care Solutions

June 21, 2022

• • Mark Cuban + Medicare drug contract would save $3.6B | Home health firms to lose $810M | Ill. payers must cover glucose monitors | BCBS of Texas denied $3M tax refund | BCBSA's new Chicago HQ | Walgreens, Buckeye Health Plan's new Health Corners

June 17, 2022

• • FTC cracks down on PBM rebates | Centene ditching 65% of its real estate | HCA, Steward scrap deal | CVS Health's new strategy exec | Report: Single-payer would have saved thousands of lives, billions of dollars during COVID| Cigna's $3.5B stock buyback

June 16, 2022

• • Soon-to-be renamed Anthem launches more brands | Best, worst states for healthcare amid COVID | 340B pay cut overturned | Vision plans ranked by customer satisfaction | HDHPs linked to delayed cancer detection

June 15, 2022

• • FTC investigates Cerebral | NJ systems scrap merger | UPMC building $1.5B hospital | CMS weighs Medicaid nursing home change | Study: Payers struggle with digital | Lawsuit seeks coverage of marijuana as behavioral drug | 5 recent payer collabs

June 14, 2022

• • FTC wants more info on Optum-LHC Group deal | 10 hospital exec resignations | Centene settles NM Medicaid probe | OU Health, UnitedHealth cut ties | Optum drops Cerebral | Anthem BCBS Va. president retiring | Hospitals lose Medicare legal challenge

June 10, 2022

• • Why Centene bought a Ritz hotel | Larry Ellison wants a nat'l database via Cerner | Blue Cross Calif. fined $1.1M | Hospitals are failing at cost-cutting | Payers back value-based startup | UnitedHealth names regional CEO | Avg. Medicare spending by age

June 09, 2022

• • Optum's top engineer leaves for startup | CMS starts fining hospitals for unposted prices | Are virtual-first health plans sustainable? | Aetna drops Cerebral | UnitedHealth invests $100M in health equity | CMS: cutting agent commission violates ACA

June 08, 2022

• • FTC to probe PBMs | Viewpoint: HSAs, HDHPs are useless | Providence Health Plan names COO | AHIP requests family glitch fix guidance | 10 hospital CEO moves | Status of 8 No Surprises Act lawsuits | Fla. payer alleges tribal policy scheme

June 07, 2022

• • Recession-proofing in heyday of HDHPs | DOJ cracks down on MA plans | 16 execs at top of UnitedHealth | Prisma tech dead, patient charged | Family complaint changes Cigna formula coverage | No transgender policy exclusions, court rules

June 03, 2022

• • Medicare hospital fund to run dry in 6 years | BCBS Minn. taps CFO, COO | Tulsa gunman targeted surgeon he blamed for pain | FTC sues to block 2 hospital deals | Payers planned $1B in premium rebates

June 02, 2022

• • 7 dead in hospital campus shootings | Insurers shun weight-loss drugs | BCBS exec leaves for startup | U of Iowa Health ups rates 6% | Hospital seeks $6M in damages from Aetna | A new managed care experiment in Calif.

June 01, 2022

• • UnitedHealthcare, WakeMed split | Highmark posts $150M loss | 40 payer exec moves | Kaiser to study shootings like preventable disease | Patients left hanging in BCBS, Springfield Clinic fallout | Feds sue Ga. payer | CareMax to buy Steward's value line

May 31, 2022

• • Hospital revenues plummet | HHS: No lower Medicare Part B premium in 2022 | Aetna faces class-action suit | Centene sheds office space | U of Vt. Health, UnitedHealth ink contract | Is Maryland's all-payer model replicable?

May 27, 2022

• • Providers dropping Anthem | UPMC's big Q1 losses | CVS debuts virtual primary care | Viewpoint: Dominance of MA plans will change everything | CMS zeroes in on hospitals with COVID outbreaks | States are coming for PBMs

May 25, 2022

• • Payers broke prior auth promises, AMA says | Dowling: Hospital leaders must stand up against shootings | No Surprises Act halted 2M bills | Feds want PBM crackdown | Patient complaint changes BCBS coverage | UnitedHealthcare's $13.6M denied care payout

May 24, 2022

• • Walmart's 18 preferred providers | UnitedHealth embracing telehealth | Cigna accused of improper claim denials | Hospitals want spotlight on payers' record profits | Opinion: Payers need behavioral 'nudge units' | Empire BCBS opens new HQ

May 20, 2022

• • Cleveland Clinic CFO exits for top payer job | Hospitals want DOJ probe of payer denials | Mayo's $142M operating gain | Health plan data breach affects 120K | Texas city gives insurance to all | Md. caps insulin costs | 8 contract disputes, resolutions

May 19, 2022

• • Tenet hospital's Medicare funding at risk | 3 letters behind single-payer defeat in Calif. | Private payers pay 224% more than Medicare | ChristianaCare to open Highmark-exclusive clinics | Anthem, SCL fight over rate boost | New Medicare website unveiled

May 18, 2022

• • Anthem rebrand approved | Novant to buy stake in MA plan | Bright Health expands leadership team | Commercial healthcare spending: States ranked | Anthem, Northside dispute heads to Ga. Supreme Court

May 17, 2022

• • Single-payer Medicare bill reintroduced | Oscar hit with investor lawsuit | 10 hospitals that best avoid unneeded care | Humana to add 100 senior care clinics | PHE set to be extended | A COVID wave 'almost like omicron'

May 13, 2022

• • Northwell offers coverage in Dominican Republic | 9 payer exec moves | How single payer would affect US: CBO | UnitedHealthcare's $100M upcoding suit can proceed | Rudeness: A care quality issue | The least insured county in each state

May 12, 2022

• • A bad Q1 for Oscar, Bright, Clover | 'Evil empire' nickname for UnitedHealth warranted: Lawsuit | NY creates office to regulate PBMs | Towns with highest insured rates | BCBS names HR chief | 3 top payers for diversity

May 11, 2022

• • Oscar Health to exit 2 states | The healthiest, unhealthiest parts of each state | Former UnitedHealth CEO made $142M in '21 | Cost of treating these diseases grew, fell most | Why HDHPs are rare in Hawaii | Meet Centene's office of the CEO

May 10, 2022

• • Hospitals tap insurers for price hikes | 6 payers ranked by Q1 profit | 100 counties with highest uninsured rate | Ark. BCBS names 5 execs | Sentara Health Plan to open care centers | 7 payers entering, exiting markets

May 6, 2022

• • Cigna's Q1 profit hits $1.2B | Aetna, Anthem execs join Waymark | UnitedHealthcare, WakeMed hit contract snag | What private insurers pay vs. Medicare, by state | Nurses make exit plans after colleague's conviction | US uninsured rate in '21: 9.2%

May 5, 2022

• • Centene to sell pharma assets for $2.8B | Cigna launches cancer consult service | 40 medical practices sue UnitedHealth | 4 of the largest health data breaches hit payers | Opinion: Call a surge a surge | 5 payer-provider contract disputes, resolutions

May 4, 2022

• • Aetna draws surgeons' ire | Prior auth 'gold cards' gain steam | Bright Health Q1 loss swells | $236M Optum, Atrius merger approved | Health plans brace for costly specialty drugs | CVS profit hits $2.3B

May 3, 2022

• • UnitedHealthcare limits Aduhelm coverage | 22 hospitals with most ER visits | Payers slam report on MA denials | HHS blocks Ga. plan to bypass ACA | 14 payer exec moves | Seasoned staff join the Big Quit

April 29, 2022

• • 19 Tenet hospitals sue Cigna | 8 top payers for diversity | Scrutinize payer mergers, AMA tells feds | 1st human bird flu case found in US | 7 Qs with Priority Health's 1st equity exec | Calif. physician sentenced in $12M Medicare fraud scheme

April 28, 2022

• • Providence Health Plan seeks 6 C-suite leaders | Molina's Q1 profit up 10% | MA plan prior auth denials concerning: OIG | Former Centene exec joins health tech startup | CMS finalizes ACA plan standardization | Tenet sues OSHA to block inspection

April 27, 2022

• • Texas orders payer to stop operations | Highest-paid payer CEOs | Centene updates leadership structure | Humana Q1 profit: $930M | Fauci: US 'out of pandemic phase' | UnitedHealthcare to change radiation prior auths

April 26, 2022

• • UnitedHealth's founder to retire from board | Centene's Q1 profit: $852M | Walmart heir creates health system | BCBS exec joins digital health startup | Ill. expands Medicaid | Can states find sustained success with public options?

April 22, 2022

• • UnitedHealth quietly buys Ore. medical groups | Kaiser exec defends Medicaid deal | Bright Health CEO's compensation: $180M | Physician indicted in $10M fraud scheme | 5 conditions make up 50% of health costs | 7 payers with best staff wellness programs

April 21, 2022

• • Humana to sell $2.8B stake in hospice arm | Payers all in on equity chiefs | 5 payer exec moves | UnitedHealth accused of inflating drug costs | 21 charged in $149M COVID fraud schemes | COVID admissions up in 20 states

April 20, 2022

• • Anthem posts $1.8B profit, faces backlash over unpaid claims | Kaiser, Cigna ink deal | Physician not guilty of 14 counts of murder | BCBS Minn. adds 4 execs | States ranked by percent of workers with HDHPs | Health plan exits Conn.

April 19, 2022

• • Opposition mounts against Kaiser's Medicaid deal | CMS' new inpatient pay rule: 10 details | Top cancer hospitals slap markups on drugs | Bright Health's legal, financial woes intensify | Anthem ordered to pay $4.5M over ER billing

April 18, 2022

• • Kaiser restructuring health plan in 2 states | 14 top paid healthcare CEOs | Centene board member resigns | Hospitals with most Medicare Advantage patients | States that restrict payer collection of race, ethnicity data

April 15, 2022

• • Bright Health to exit 6 states | CMS revises surprise-billing arbitration | Largest commercial payer in each state | 10 places COVID cases may jump most | 12 UnitedHealth, Centene updates | ACA's 5 most popular provisions

April 14, 2022

• • UnitedHealth's $80B Q1 | 40% of top execs left NY health plan | Tech burned by nurse sues Hackensack | Anthem ordered to keep Northside contract intact | Payers' fitness tech discounts | ACA repeal off the table for Grassley

April 13, 2022

• • 6 payers adding new C-suite roles | Public health emergency renewed | Scrutiny builds over MA plans | Delta ends insurance surcharge for unvaccinated staff | Providence to pay $22.7M to settle unnecessary care suit | States ranked by suicide rate

April 12, 2022

• • Hospitals with most Medicare, Medicaid patients | Best payers to work for: Fortune | CEO added to $120M Medicare fraud case | UnitedHealth subsidiary ordered to pay $200M over coverage denials | Colo. fines Bright Health $1M

April 8, 2022

• • 8 health insurance execs on the move | Longtime Centene CEO dies | UnitedHealthcare launches virtual PT | 9 hospitals cutting services | Mich. reforms prior auth rules | 5 best healthcare cos. for career growth

April 7, 2022

• Why insurers, health systems are breaking up | Fla. system strikes $20M false claims deal | Calif. investigating Centene | Atlanta hospital to end inpatient care | 5 payer-provider contract terminations | Kan. hospital CEO resigns

April 6, 2022

• 20 top hospitals' payer mix | Maine hospital to drop Anthem over $70M in unpaid claims | 33 billionaires in healthcare | Payers cut brokers' commissions | MBAs in management linked to lower employee pay | Tivity Health strikes $2B deal

April 5, 2022

• Biden wants to update ACA | Former Humana exec lands CEO role | Optum, Change set $650M breakup fee | 7 hospitals laying off workers | 10 least healthy US cities | How should telehealth be reimbursed?

April 1, 2022

• BCBS Ill. president abruptly exits | UnitedHealthcare, Broward sever contract | Health Care Service Corp. shakes up C-suite | 9 payers fined by states | Why physicians resist telehealth | Time for more nurse CEOs?

March 31, 2022

• Ransomware group claims to steal 850K records from health plan | RI fines UnitedHealthcare over denials | CMS floats hospice pay rule | States ranked by hospital admission rates | 4 payer execs named to list of 75 Black healthcare leaders to know

March 30, 2022

• Anthem exec joins virtual care co. | Mark Cuban's pharmacy adds 50+ drugs | A look at UnitedHealth's M&A deals | 5 payer exec resignations, retirements | UnitedHealthcare, Vt. system strike new contract | Why rudeness is on the rise

March 29, 2022

• UnitedHealth strikes $5.4B deal | Ga. fines BCBS $5M | Feds restore halted Medicaid funding to Texas hospitals | Biden's budget: 9 healthcare notes | Ore. health plan confirms data breach affecting 10K + 5 other breaches

March 25, 2022

• 2 min. may cost Tufts Health Plan $400M | Healthcare CEOs' big paydays | BCBS of Kan. reports data breach | Optum to expand in 37 states with acquisition: report | Mich. passes prior auth reforms | 7 payer exec moves

March 24, 2022

• Allina Health-Aetna taps CEO | Highmark reports data breach | CommonSpirit launches outcome-based pay model | Mich. lawmaker eyes single-payer healthcare | Anthem's bid to toss $51M escrow suit denied

March 23, 2022

• Centene names CEO | Wis. bans health insurer | ProMedica's health plan to lay off 200 | TeamHealth sued over alleged upcoding | UnitedHealth's mental health claim denials were reasonable: Appeals court | Humana issues $750M debt offering

March 22, 2022

• Cigna exec to join Tenet | What 4 payer CEOs earned in '21 | Ill. fines BCBS over contract termination | Kaiser sued over alleged underpayments | M&A fuels Highmark's $440M profit | NY system tries to recoup $228M from insurer | 7 billing fraud cases

March 18, 2022

• 12 states with highest uninsured rates | AMA eyes suit targeting prior auth 'abuses' | Is single-payer feasible in the US? 1 CMO answers | Anthem may dodge suit over $415K bill | Where are Americans quitting most?

March 17, 2022

• UnitedHealth blasts DOJ challenge to Change deal | BCBS sues Walgreens | Anthem Blue Cross ends payment of consultations | 10 most segregated hospital markets | Humana workers go back to office after 2-year hiatus

March 16, 2022

• MA plans got $12B in excess pay: Watchdog | $36K hospital bill goes viral | Molina called out over reimbursement | Results from Banner-Aetna partnership | Humana, La. hospital hit contract snag | COVID cases rise in UK, as do questions

March 15, 2022

• Payers slam Mass. system's $2.3B expansion | 6 'most ethical' payers | Calif. targets payer costs | Biden wants stricter payer mental health parity enforcement | 6 payer-provider contract disputes, resolutions

March 11, 2022

• Deltacron: What we know | Oscar, Bright Health, Clover post losses of $500M+ | BCBS, Memorial Hermann reach deal | Marketplace plan enrollment, by state | Calif. physician charged in $36M Medicare fraud scheme

March 10, 2022

• Anthem to change name | 12 physicians sentenced for $250M billing fraud | 10 drugs that cost Medicare the most | CareFirst names diversity director + 7 other payer exec moves | Anthem sues ex-president, alleges trade secret theft

March 9, 2022

• Oscar COO to resign | Aetna, Optum must face 'dummy code' suit | A look at AMA's single-payer fight | 151-day telehealth expansion on the table | Vt. system urged to resolve spat with UnitedHealthcare | 5 payers flagged for coding, reimbursement errors

March 8, 2022

• Broward, UnitedHealthcare hit contract impasse | 9 top Medicare, Medicaid plans | Calif. payer fined $55M for care authorization delays | HHS: COVID funding is used up | 250+ orgs reject CMS' direct contracting model rebrand

March 4, 2022

• Optum's provider + growth strategy | Bright Health lays off 150 | Vt. system wants out of UnitedHealthcare contract | Centene withheld overtime pay, suit claims | Senate votes to end COVID emergency as Biden seeks more aid

March 3, 2022

• Tenn. physician convicted of $50M billing fraud | Clover Health must face suit alleging it misled investors | 15 states hit most, least by 'Great Resignation' | Civica to make low-cost insulin; BCBS backs effort | 8 CMS actions

March 2, 2022

• Largest payer in 50 states | Biden's new COVID plan | UnitedHealthcare to nix paper checks | 25 US hospitals among Newsweek's best in the world | Where Cigna may invest $450M in venture capital | HHS to revise surprise-billing arbitration

March 1, 2022

• 100K members in limbo as BCBS, Memorial Hermann split | Cerner CEO joins Humana board | UnitedHealthcare axes paper prior auths | Cigna to buy back $6B in stock | Anthem must face suit over mental health coverage | The nurse shortage caveat

February 25, 2022

• Centene CEO to take medical leave | 17 'overpaid' healthcare chiefs | Physicians: ACO redesign is 'direct contracting in disguise' | The staffing story we still need to get right | Top 5 healthcare billionaires | The UnitedHealth-Change deal in 13 dates

February 24, 2022

• UnitedHealth to battle DOJ over $13B Change deal | 15 best, worst cities for jobs | 5 payer exec moves | Judge rejects HHS surprise billing rule | BCBS of Tenn. joins innovation alliance | Patients are coming after hospital prices

February 23, 2022

• Anthem BCBS payment delays linger | $80K bill highlights No Surprises Act loophole | DOJ has until Feb. 27 to block UnitedHealth-Change deal | Blue Shield exec: Patients expected Sutter contracts | 9 healthcare billing fraud cases

February 22, 2022

• Humana targets board refresh | State of single-payer proposals in 21 states | Meet Cigna's C-suite | BCBS affiliate sues Jazz Pharmaceuticals over 'gobsmacking' drug price | 29 burned out specialties, ranked

February 18, 2022

• UnitedHealth taps 1st sustainability chief | 'Big 6' payers: 60 facts | 453 hospitals at risk of closure | OIG flags coding errors at Tufts Health Plan | 5 legal actions involving payers | Fla. health plan looks to speed prior auths by 10 days

February 17, 2022

• BCBS of La. must face antitrust suit | Mayo: Out-of-network appointment ban not about money | 7 payer exec moves | 'Junk' health plans thrust into limelight | AHIP: Hospitals charge double specialty pharmacy rates for same drugs

February 16, 2022

• 'Big 6' payers ranked by profit | Ill. hospital loses Medicare funding | Bright HealthCare CEO to resign | Fla. physician convicted of $110M billing fraud | Priority Health reports data breach | Omicron subvariant in 47 states: 5 updates

February 15, 2022

• 2 health systems buy stake in W.Va. payer | Payers forced into Sutter contracts, former Blue Shield exec testifies | Mayo bars some out-of-network appointments | 6 payers ranked by MA enrollment | America's untapped COVID strategy

February 11, 2022

• Aetna loses mental health coverage suit | 6 payers ranked by membership | Miss. moves to end Centene's Medicaid contract | Lab owner sentenced for submitting $42M in fraudulent claims to UnitedHealthcare | 6 medical bills making headlines

February 10, 2022

• 'Big 6' payers ranked by '21 revenue | Layoffs hit Pa. system | Biden to remove state Medicaid fees | 96,694 hospitalized with COVID | 810 drugs saw price hikes in 1 mo. | Members forgo reimbursement for at-home COVID tests

February 9, 2022

• Blue Cross CFO joins Providence board | Meet UnitedHealth's C-suite | Omicron found in deer | Aetna's annual revenue: $82B | Mich. surgeon guilty of $19M billing fraud | NM payer sued over 63K member data breach | Medi-Cal suspends prior auths for drugs

February 8, 2022

• Centene annual revenue: $126B | PBMs ranked by market share | CMS penalizes 38 top hospitals | Amazon to add clinics in 20 cities | Humana: 20 things to know | Nurse allegedly sets coworker on fire at NJ hospital | 6 best payer tools: KLAS

February 4, 2022

• OIG: Payer overcharged Medicare $54M | Kaiser Medi-Cal contract raises concerns | Pa. physician fired over ivermectin scripts | 9 CMS updates | Top health issue in all 50 states | UnitedHealth workers win class certification in 401(k) suit

February 3, 2022

• UnitedHealthcare subpoenaed over data breach | CMS floats 8% rate boost for MA plans | Cigna's annual profit sinks 37% | Medicare to cover at-home COVID tests | Blue Shield of Calif. adds multinational finance exec to board | 10 exec resignations

February 2, 2022

• Humana's annual profit dips 27% | Union accuses HCA of Medicare fraud | UnitedHealthcare underpaid providers $23.9M for COVID vaccines | 6 'most admired' payers | An unexpected omicron symptom | DOJ recovers $5B from false claims

February 1, 2022

• Single-payer bill dies in Calif. | CMS cuts pay to 764 hospitals | GuideWell buys Puerto Rico insurer for $900M | Cigna taps president for US government unit | Judge extends Northside-Anthem contract | Omicron subvariant transmissibility: 4 findings

January 28, 2022

• Aetna loses cancer coverage suit | How payers view MA market | 5 states set COVID hospitalization records | Health plans may be key to surviving labor woes | CHS owes fees in $98M fraud case | What happened to contact tracing?

January 27, 2022

• Cigna discussed acquisition with Centene in '21 | 10 payer exec moves | Next variant could be more transmissible: WHO | Mich. seeks probe of Eli Lilly insulin costs | ACA sign-ups hit record | Payers: HHS gets air ambulance surprise-billing rule right

January 26, 2022

• Anthem commercial growth flounders | SSM Health warns of insurance scam | Person shot in NY hospital ED | Mass. system ordered to curb costs | Biden explores Medicare coverage of at-home COVID tests | 113 great healthcare leaders

January 25, 2022

• Change mulls asset sale to aid UnitedHealth deal | BCBS names CISO | Payers fall short on mental health parity: Labor Department | Omicron subvariant found: 8 notes | Anthem, Northside dispute broadens | 27 meds with prices slashed at Mark Cuban's co.

January 21, 2022

• Hospital market power boosts insurance cost: CBO | BCBS of Kansas City hit with antitrust claims | US nearing omicron peak | How 13 payers handle at-home COVID test reimbursement | Does virtual care save money?

January 20, 2022

• Optum inks deal with Calif. system | Anthem: 20 things to know | 122 orgs fight single-payer proposal in Calif. | 3 states where omicron is peaking + 6 where delta lingers | Humana to expand senior care clinics to 12 states

January 19, 2022

• UnitedHealth annual revenue tops $287B | Omicron riskier for young people | 32 lawmakers to CMS: Adjust Part B premium | Premera Blue Cross to open member-only clinics | 5 CEO resignations | Aetna expands at-home care network

January 18, 2022

• Oscar Health reports data breach: 5 details | 20 hospitals tied to most 'unnecessary' care | Bon Secours Mercy Health settles false claims case | 7 payer legal disputes, settlements | UnitedHealth's Dr. Berke: 3 needed steps of a COVID mitigation strategy

January 14, 2022

• Payers: Expect messy rollout of at-home COVID test rule | Physicians charged in $100M fraud scheme | Aetna, Trinity hospital ink contract | Cigna: 20 things to know | Fla. won't enforce CMS vaccine rule | ICU bed capacity, by state

January 13, 2022

• Texas hospital loses Medicare contract | Kaiser, Morgan Health partner | Excellus BCBS names 1st female CIO | 8 hospital layoffs | 5 payers among best companies for remote work | Calif. sues cost-sharing ministry over unauthorized health plan sales

January 12, 2022

• CMS plans to limit Aduhelm coverage | Healthcare's best places to work | UnitedHealthcare settles underpayment suit for $10M | Centene adds 5th board member | Anthem moves to halt order extending Ga. hospital's contract

January 11, 2022

• Insurers must cover at-home COVID tests + payers react | 29 best healthcare jobs | HHS to CMS: Reassess Part B premium | 26 medical orgs fight surprise-billing process | 8 exec resignations | UnitedHealth subsidiary ordered to pay $20M in legal fees

January 7, 2022

• Single-payer healthcare on the table in Calif. | 5 payer exec moves | WHO not concerned about variant in France | OIG flags coding errors at Healthfirst | Anthem sued over overtime pay | CMS floats Medicare Advantage, Part D rule

January 6, 2022

• Centene names transformation chief | Physician faces charges over $46M in Medicare billings | 11 short-staffed hospitals halt services | Humana delays office return, mandates boosters | 13 states set COVID hospitalization records

January 5, 2022

• Medicare funding at Ill., Texas hospitals at risk | UnitedHealthcare: No changes to ER coverage policy | UPMC hit with $250K claims notification penalty | Aetna: 20 things to know | 4 US health plans among world's largest insurers

January 4, 2022

• Centene buys Magellan for $2.2B | Ex-Aetna CEO to co-lead hedge fund | Court orders Anthem to keep 400,000 hospital patients in-network until Feb. 1 | HHS floats rule for ACA plans | New variant found in France | No Surprises Act is in effect: 9 details

December 23, 2021

• 10 states COVID may hit hardest by NYE | 20 things to know about UnitedHealth | Lawmakers want Summa Health deemed 'distressed' | Anthem to acquire Medicaid contract | Nonprofit hospitals in these 10 states report lowest expenses | Tenet closes $1.1B deal

December 22, 2021

• 8 hospitals flagged for billing errors | 5 recent payer disputes | Omicron no less severe than delta: study | Feds approve Ark. Medicaid expansion overhaul | 20 things to know about Centene | 12 hospital bankruptcies, closures | Booster rates by state

December 21, 2021

• Biden's plan to fight omicron: 5 details | Payers issued $2B in premium rebates | IU Health freezes prices | 3 insurers penalized for health parity violations | FBI investigates vaccinations at hospital CEO's church | Anthem, Memorial Health ink contract

December 17, 2021

• Hospital CEO: Virtual plans bring out the worst in healthcare | Calif. physician guilty in $355M billing scheme | States where COVID hospitalizations cost most, least | Oracle nears $30B deal for Cerner | Ore. Health Plan tagged for improper billing

December 16, 2021

• Cigna adds former Citigroup exec | Optum extends $13B merger deadline | 4 most common omicron symptoms | AHA, AMA gain support in battle over surprise-billing rule | CMS vaccine mandate revived in 26 states | Amazon taps health leader

December 15, 2021

• 79 payer C-suite moves | Texas hospital's Medicare contract in jeopardy | Scripps' EHR automates price markups | Omicron spread: CDC, WHO updates | Meet Centene's incoming board members | 8 called-off hospital deals

December 14, 2021

• Centene CEO to retire | Man charged in $38M UnitedHealth, BCBS false claims scheme | HHS sends $9B to providers | TeamHealth CEO discusses payment litigation | Vt. mandates at-home COVID test coverage | US medical debt: 11 numbers to know

December 10, 2021

• 5 payers tagged for coding, reimbursement errors | 6 states set COVID records | Anthem JV launches virtual primary care nationwide | Hospitals sue feds over surprising-billing rule | Senate votes to avert Medicare cuts | 8 top children's hospitals

December 9, 2021

• CMS delays payer data exchange requirements | 9 hospitals laying off workers | Oscar adds 1,300 providers to network | The healthiest, unhealthiest states | CareSource, TrueCare forge alliance | How much hospitals charge for COVID vaccines in each state

December 8, 2021

• Cigna names digital chief | Jury: UnitedHealth owes TeamHealth $60M | 72 top teaching hospitals | Mo., Okla. see split results after expanding Medicaid | Ill. hospital CEO uncovers potential misappropriation of funds | House votes to avert Medicare cuts

December 7, 2021

• Centene pays $27.6M to settle drug overbilling claims | Payers fear COVID test price gouging | Humana Foundation names CEO | Calif. hospital plans 677 layoffs | 5 states set COVID records | Trinity doubles operating income on health plan sale

December 3, 2021

• UnitedHealthcare, Optum to step up collaboration | 2 top Humana execs get new roles | 73 hospital closures, state by state | Hospitals fail to stop Medicare cuts | BCBS of Mass. commits $25M to address health disparities

December 2, 2021

• Biden plan requires insurers to pay for at-home COVID tests | Texas hospital inks $18.2M false claims settlement | Cigna, HCA expand partnership | NY systems make 4 C-suite changes | AMA: Allowing Medicare cuts would be 'reckless'

December 1, 2021

• The worst COVID hot spot in the US | Payers respond to rising mental health concerns | 9 health systems with strong finances | CMS vaccine rule blocked nationwide | HCA hospital keeps Medicare contract after corrections | Point32Health names 2 execs

November 30, 2021

• Medicare payment rule baffles Supreme Court | UnitedHealth names CMO, expects at least $317B in revenue next year | Healthcare worker vaccine rule blocked in 10 states | Independence Blue Cross, Penn Med expand contract | HCA to add 3 hospitals

November 26, 2021

• Higher penalties won't sway all hospitals to post prices | 20 states with most, least expensive premiums | Ex-Calif. hospital execs must face charges | Oscar, Stride Health partner | Viewpoint: Don't demonize healthcare execs over profits

November 24, 2021

• Houston hospital set to lose Medicare contract | Oscar, Emory partner on health plan | Feds ask court to reinstate vaccine-or-test rule | 20% of large businesses consider hiking premiums for unvaccinated workers | Surprise healthcare billing: 4 notes

November 23, 2021

• BCBS of NC accused of abusing surprise billing ban | HCA defeats billing fraud claims | Humana, Allina ink value-based deal | HHS sends $7.5B to providers | Fauci's holiday guidance as COVID cases climb

November 19, 2021

• Insurers balk at paying for Aduhelm | Highmark CEO elected AHIP board chair | Physician sentenced for defrauding insurers of $29M | House passes $1.7T spending bill: 6 healthcare notes | Calif. hospital to lay off 328

November 18, 2021

• Feds require health plans to report coverage costs | BCBS Assoc. names board chair | CVS to close 900 stores | 5 payer lawsuits | CommonSpirit eyes 14-hospital sale | Medicare Advantage enrollees drawn to $0 premiums

November 17, 2021

• Will virtual-1st plans stick? | 152 lawmakers push back on surprise-billing rule | Ex-Sanford CEO got $49M payout after abrupt exit | Payers, providers seeing more cut contracts | States ranked by healthcare affordability | 15 recent CMS actions

November 16, 2021

• UnitedHealth only paid surprise bills after complaints, former exec says | 7 payer-provider disputes, resolutions | COVID makes spotty resurgence | CMS: Improper payments down $20.7B | 20 most cost-efficient systems | Amazon Care's new customer: Hilton

November 12, 2021

• Cigna, BCBS name new leaders + 3 other payer exec moves | Walmart heir wants to reform healthcare | 8 hospitals laying off workers | UnitedHealthcare, Prisma ink contract | CMS nixes rule for 'breakthrough' tech | Bright Health Q3 loss: $296M

November 11, 2021

• 6 payers ranked by Q3 profits | Midwest is nation's COVID hotspot | W.Va. hospital halts strikers' health benefits | Cost of family health insurance tops $22K a year | 10 states challenge CMS' vaccine mandate | BCBS of Mass. commits $16M to nonprofits

November 10, 2021

• Anthem threatens to end contract with Ga. system after 30 yrs. | Feds probe Oak Street Health | 41 'F' and straight-'A' hospitals: Leapfrog | Aetna faces whistleblower suit | Molina names NY plan president | Clover Q3 revenue up 153%

November 9, 2021

• Memorial Hermann, BCBS swap termination notices | 10 most cost-efficient hospitals | Kaiser grows to 12.5M members as income sinks | UnitedHealthcare, Prisma hit contract snag | 5,400-physician network to unwind in Mich. | 6 payers' medical loss ratios

November 4, 2021

• TeamHealth fires back at UnitedHealth | Investor with $900M stake wants Centene to refresh board | Healthcare affordability: Where does your state rank? | Cigna Q3 revenue: $44.3B | UPMC gains support in battle with feds

November 3, 2021

• Insurers accused of restricting $90B in payments | CMS drops 3 payment rules: 12 takeaways | Why are retirees delaying Social Security? | Humana Q3 revenue hits $20.7B | 5 top coding issues that result in denials | Centene's PBM: A timeline

November 2, 2021

• Jefferson acquires insurer | 11 systems with strong finances | NY system halts strikers' health benefits | CEO resigns from Calif. hospitals | Geisinger settles billing fraud claims for $18.5M | Insurer withholding $10M in payments, lab alleges

October 29, 2021

• Cigna + 14 other fastest-growing healthcare cos. | 39 hospitals hit with max readmission penalties | Humana, Ochsner partner on mobile clinics | Top drivers of claim denials | Former BCBS Association exec joins AmeriHealth Caritas

October 28, 2021

• UnitedHealth sues TeamHealth, alleges $100M fraud | BCBS of Minn. names CEO | 2,499 hospitals dinged for high readmissions | Aetna to cover gene therapies | 6 updates on coronavirus variants | Cigna CEO: 3 trends to shape future of healthcare

October 27, 2021

• DOJ: Kaiser defrauded Medicare of $1B | Centene to shake up drug benefit business | Cigna expands telehealth | States ranked by vaccine hesitancy | Stride gets $47M to bring benefits to gig workers | 5 payers adopt virtual-first models

October 26, 2021

• Anthem wants investigation of Sentara | 10 ZIP codes with highest uninsured rates | Aetna to shift to digital payments | FTC tightens reigns on merger control | Cigna, Houston hospital hit contract impasse

October 22, 2021

• BCBS Association names 2 top execs | Ascension, AdventHealth to split | UnitedHealth to retroactively pay providers for vaccines | Ind. system must face false claims suit | Delta subtype found in US | Cigna expands Medicare Advantage plans

October 21, 2021

• Ransomware hit exposes Anthem, Humana members' info | Oscar partners with 3 Colo. systems | Texas nurse found guilty of killing 4 patients | OIG: TennCare may owe $400M | Vaccine-driven turnover at 32 systems | 4 health insurance leaders' goals for '22

October 20, 2021

• OIG: UnitedHealth top recipient of questionable payments | COVID hospitalization charges by state | Kaiser workers rebel against new wage system | Anthem Q3 profit up 580% | Blue Shield of Calif., Google Cloud team up

October 19, 2021

• UnitedHealthcare launches virtual-first plan | 8 payers ranked by customer satisfaction | Provider sued after Medicare freeze | Walmart enters self-insured market | 4 states overwhelmed by COVID hospitalizations | 26 exec moves | EmblemHealth lays off 89

October 15, 2021

• Payers lean into virtual-first plans | COVID test kits recalled | Best Medicare Advantage plans: US News | 4 hospital bankruptcies | Medicare rule has AHIP concerned | CMS asks 32 hospitals for price-posting plans | Medicare open enrollment: 5 notes

October 14, 2021

• UnitedHealth Q3 profit tops $4B | Viewpoint: Downcoding a 'revenue grab' by insurers | Anxiety, depression rates by state | Surprise billing rule could slow premium growth | Pa. hospital must face overpayment suit | EHRs can predict physician exits

October 13, 2021

• Viewpoint: Medicare Advantage is 'money machine' for payers | Cigna ranked among world's best employers | UPMC defends billing in battle with feds | Why an $8.5B system partnered with Optum | Unvaccinated healthcare workers demand jobs back in Texas

October 12, 2021

• Physicians urge feds to investigate UnitedHealth | 10 highest-paid health insurance CEOs | Northwell shifts to direct contracting for employee insurance | 11 hospital closures | DOJ to join $800M suit against Tenn. system | Ochsner launches health plan

October 8, 2021

• Cigna inks $5.7B divestiture deal | Humana hires CMO for primary care business | Former healthcare exec sentenced for $59M fraud | CMS releases Medicare Advantage star ratings: 8 notes | BCBS of Tenn. fires unvaccinated workers

October 7, 2021

• Optum teams up with SSM | Ex-UnitedHealth leader lands role at Walmart | 15 wealthiest people in healthcare | 11 hospitals hit with credit downgrades | Teladoc rolls out virtual care service for payers | 10 most trusted system brands

October 6, 2021

• Anthem shakes up leadership | UnitedHealth to require COVID-19 vaccinations | NY suspends prior auths | Suspect in Pa. hospital shooting charged with murder | Kaiser puts 2,200 workers on leave | CMS overpaid $636M for neurostimulator surgeries: OIG

October 5, 2021

• UnitedHealthcare, Anthem behind on billions in payments | 256 hospitals get warning over undisclosed prices | Trinity revenue hits $20B with payment rate increases | Medicare Advantage updates from 7 payers | 1,400 unvaccinated workers leave Northwell

October 1, 2021

• CMS' surprise-billing rule is 'underserved gift' to payers: AMA | Merck's antiviral pill cuts COVID hospitalizations | Centene settles 2 payment disputes | UnitedHealth keeps Medicare Advantage dominance | Ochsner workers charged for unvaccinated partners

September 30, 2021

• UnitedHealthcare, Wellstar hit contract impasse | MA premiums to dip in 2022: CMS | Death allegedly linked to cyberattack on Ala. hospital | SDOH missing in nearly 99% of Medicare claims: study | No Surprises Act: 12 things to know

September 29, 2021

• Walmart Health struggles to bill payers | Humana reaches $11M settlement with nurses | WellCare partners with Carolina Panthers | CEO, COO exits prompt concern at Colo. system | Health insurance markets increasingly concentrated: AMA

September 28, 2021

• Centene exec resigns | Pa. hospital to close | UnitedHealth develops calculator for COVID testing programs | Humana sues Biogen | Intermountain moves into flat-priced imaging | 2 largest nonprofit systems see finances bounce back

September 24, 2021

• UnitedHealth teams up with Apple | Why 3 hospital bills went viral this year | Humana, Centene sue Merck over alleged price inflation scheme | 9 hospitals laying off workers | 94% of Californians insured, but many lack access to care

September 23, 2021

• Cigna shakes up leadership | Mich. physician convicted in $100M scheme | BCBS of Mass. adds equity measures to payment models | Humana: Ex-CMO fired for inappropriate texts | 30 Ala. hospitals in jeopardy | CMS approves Clover Health's expansion

September 22, 2021

• Insurers claimed $9.2B in questionable payments: OIG | Ascension's tech arm to cut 330 jobs | 10 states with steepest COVID case surges | Blue Shield of Calif. partners with Venus Williams | Medicare benefit expansion: 13 stats to know

September 21, 2021

• 4 NJ hospitals cut contract with UnitedHealthcare | Hospitals bill insurers $317K for complex COVID cases | Top payers ranked by customer satisfaction | Aetna, BCBS, Cigna, Anthem's virtual care strategies: 7 notes | Hospitals to lose $54B this year

September 17, 2021

• Calif. hospital ends Anthem contract amid dispute | 7 systems lose employees over vaccine rules | Texas hospital explains $555K billing error | 10 best, worst states for health insurance coverage | FEMA to cover NY system's $900M COVID tab

September 16, 2021

• Anthem hit with federal penalty over plan spending | Intermountain, SCL to merge 33 hospitals, insure 1M | CDC launches payer feedback toolkit | Physician settles false claims suit for $6.7M | 1 killed in accident involving MRI at Utah hospital

September 15, 2021

• Feds penalize 3 UnitedHealthcare plans | 10 states with steepest COVID case surges | Texas 'gold card' law to cut prior auth delays | NY health plan hit with false claims suit | Top 20 business schools | Wellcare teams up with Joe Montana

September 14, 2021

• CMS pitches disclosure rules for insurers: 7 things to know | 19 exec moves | Blue Shield of Calif. partners with Walgreens | Texas hospital may close due to vaccine mandate | Healthcare billing fraud: 8 suits, settlements

September 10, 2021

• Delta Air Lines' insurance surcharge spurs vaccinations | UnitedHealthcare pays less for COVID shots, pediatricians say | Biden's vaccine mandates: 9 details | AMA tells employers to challenge prior auths

September 9, 2021

• Anthem, BCBS hit with antitrust suit | UnitedHealth: Shifting procedures out of hospitals saves $684 on average | 8 hospitals, systems halting nonemergency surgeries | UMass, partners launch Medicare Advantage plan

September 8, 2021

• WVU Medicine to launch insurance subsidiary for 30K employees | Humana's Medicare Advantage COVID-19 claims surge | The best, worst states to work in | Only physicians on Okla. Medicaid oversight board removed

September 7, 2021

• The metro with the highest uninsured rate in each state | A third of US workforce opts for gig work, foregoing employer benefits | 10 states with largest COVID-19 case increases | 5 things to know about the US booster plan

September 3, 2021

• State of emergency extends MedStar's Medicaid contract | Feds file false claims suit against UPMC | 5 recent payer partnerships | Ex-Wis. system VP charged in kickback scheme | 10 ACOs with most shared savings | Healthcare workers face threats, harassment

September 2, 2021

• Va. systems clash over hospital-owned health plans | Lab owner pleads guilty to $73M Medicare scheme | CMS names consumer information leader | Centene consolidates Medicare arms | 50 states ranked from healthiest to unhealthiest

September 1, 2021

• Medicare Part A funds to run out in 2026 | Provider sues to bar Centene subsidiary from Mo. contract | Ivermectin prescriptions soar despite federal warnings | A fourth of pandemic marriages linked to health insurance

August 31, 2021

• UnitedHealth, CVS head to court over PBM information | 10 largest BCBS affiliates by membership | 2 top FDA vaccine leaders to retire | 4 drugs on Optum's watchlist | CareFirst, Highmark launch union plan

August 27, 2021

• Biden's $3.5T bill 'biggest health expansion' since ACA | Cigna relocates 2,100 employees | 5 healthiest, unhealthiest metro areas | Walmart hires former Highmark exec as health, wellness CFO

August 26, 2021

• Return-to-office plans: Where 5 payers stand | Ill. requires insurers to cover mental healthcare | Depression + anxiety: States ranked | The state of employer-based insurance in 8 stats | Vaccinations up in 46 states, down in 4

August 25, 2021

• Delta to charge unvaccinated employees extra $200 a month for health insurance | GuideWell buys Puerto Rico insurer for $900M | Top 20 healthcare lobbyists by spending | Cigna launches $2B stock buyback agreements

August 24, 2021

• CMS to delay enforcement of payer price disclosure | 6 hospital layoffs | MedStar tightens insurer network | CMS urges MA plans to relax prior authorizations | Virtual-only plans: What Aetna, Kaiser + more envision

August 20, 2021

• Insurers stop waiving cost-sharing for COVID care | UnitedHealthcare to end paper proof of payment in 12 states | NJ health plan can't pay out claims | How GM's direct contracting experiment has fared

August 19, 2021

• Blue Shield winds down oversight of COVID-19 vaccine rollout in Calif. | Kaiser sued over $41.7M in payments | COVID hospitalizations at all-time highs in 7 states | Nev. hospital cuts ties with Prominence HealthFirst

August 18, 2021

• Humana CFO details home health push as Kindred deal closes | Anesthesiologists sue UnitedHealth over surprise bills | 3 studies guiding the US booster plan | BCBS of NC partners with provider on clinics

August 17, 2021

• UnitedHealthcare acquires insurer from Minn. system | CareFirst BCBS mandates vaccines | 10 states with highest COVID-19 case increases | RI attorney general calls out premium hikes | Providence Health Plan gets new CEO

August 13, 2021

• Anthem to open 50 medical centers with CareMax | UnitedHealthcare loses Medicare overpayment appeal | Don't let 'elective' fool you, physicians urge | Kaiser, Desert Care hospitals to end contract

August 12, 2021

• HHS sued over insurance price transparency rule | ProMedica can end rival's insurance contracts | UnitedHealthcare settles mental health case | COVID-19 cases peak in 3 states | Why a hospital bill from 1955 went viral

August 11, 2021

• Medicaid work rules out in 3 more states | UnitedHealthcare data used in influential surprise billing study | How vaccination rates are changing in each state | Sentara settles improper claims allegations

August 10, 2021

• HCSC goes big on Medicare Advantage | Ascension Mich. settles false claims case | People go to great lengths for unauthorized boosters | How insurer profits changed in a year | CMS targets 'most favored nations' model

August 6, 2021

• Wash. system to sever contract with Premera Blue Cross | Optum's growth in 13 numbers | Ascension settles false claims allegations | 7 states account for half of COVID cases, hospitalizations | Lab countersues BCBS of Kansas City

August 5, 2021

• OIG auditing Aetna MA plans | Cardiologist sentenced for 'fountain of youth' billing scam | ICU capacity strained in Ark., Miss. | Cigna's profit dips to $1.5B | Telehealth prices at 25 hospitals

August 4, 2021

• Aetna, CVS to enter ACA marketplace in 8 states | 7 ways this surge is different | PE firm creates value-based care co. | UnitedHealth consultants lose class certification in wage suit | US ranks last in healthcare

August 3, 2021

• Pa. system sues insurer for $1B | CMS' inpatient payment rule: 7 notes | NPs get prison time for Medicare fraud | How Anthem, UnitedHealth + 3 payers fared in Q2 | Humana names new president

July 29, 2021

• Blue plans not 1 entity, providers argue | Fla. sees record high COVID-19 admissions | Viewpoint: 'Medicare for All' movement lost its punch | EmblemHealth CEO on being a provocateur for progress

July 28, 2021

• Hospitals holding up Wash. state's public option, lawmakers say | Humana sues Regeneron over drug pricing | COVID-19 hospitalizations up in 47 states | NY insurance CEO: 'Healthcare is not a digital event'

July 27, 2021

• CMMI: 4 conclusions after a decade of payment experiments | US News: 20 best hospitals + No. 1 by state | 'Medicare for All' rallies held in 50 cities | Cigna, MultiPlan ask judge to toss underpayment suit

July 23, 2021

• BCBS of Tenn., CHI Memorial hit contract impasse | Telehealth costs at Amazon, Walmart, Walgreens, CVS | 3 states tied to 40% of COVID-19 cases | BCBS of Kansas City sues lab, alleging inflated claims

July 22, 2021

• Mo. Medicaid expansion upheld | BCBS of SC, feds settle discrimination allegations | 18 systems with strong finances | Cigna, Oscar tag team virtual primary care | Medicaid coverage gap a payers' boon

July 21, 2021

• Anthem, Dignity end contract | Healthcare consolidation 'warrants being looked at': AHIP CEO | UnitedHealthcare CMO departs | 44 states with rising COVID-19 hospitalizations | Centene CEO: What would make us stay in Mo.

July 20, 2021

• UnitedHealth CEO: Get used to lower ER use | CMS' outpatient payment rule for '22: 7 notes | 10 states with highest COVID-19 case increases | Prime, 2 physicians settle false claims case | Clover CEO clears air

July 16, 2021

• Hospitals blast UnitedHealth profits | Why this insurance CEO thinks big healthcare brands are losing significance | Mo. governor, Mercy execs clash | Centene restructures leadership

July 15, 2021

• Anthem, Kroger team up for Medicare plans | UnitedHealth's profit slips | Aetna drops $50M overbilling suit against Mednax | 8 employers to watch in direct contracting | Top 25 places to live

July 14, 2021

• New CMS rule would update Medicare shared savings, telehealth coverage | Where COVID-19 cases are up 404% | Why Calif. physicians want Aetna case reviewed | Aduhelm gets a no from more private payers

July 13, 2021

• Humana quietly funding clinics | Physician sentenced for defrauding 3 insurers | Hospitals call Biden EO 'misguided' | Medicare starts Aduhelm coverage review | Cigna wins out on NFL claim suit

July 9, 2021

• Biden EO calls out health insurer consolidation | 15 best, worst states for retirement | Trinity may sell stake in Medicaid plan to Highmark | CMS' 2022 payment rules: 21 notes | BCBS of RI CMO heads to Olympics

July 8, 2021

• Aetna cataract policy draws physician backlash | Lab CEO charged in $86M Medicare billing scheme | RIP 'Uber of healthcare' | Biden to target noncompetes | Humana downsizes in Wis.

July 7, 2021

• Amazon Care wants Aetna, BCBS plans to cover its services | Insurer startups hiring more physicians | CMS targets retroactive ED denials | COVID-19 hospitalizations up in 21 states | Humana to hire 200

July 6, 2021

• UnitedHealthcare's ER policy violates patient protection laws, physicians say | COVID-19 cases up in 17 states | Medicare has new director | Beaumont-Spectrum merger could spark tougher payer negotiations

July 2, 2021

• BCBS Association innovation chief: 2 things that need to change | DOJ targets EHR false claims | Healthcare spending per capita, by state | 6 payer CEOs on AHIP's board | Cigna gets win in NJ lab lawsuit

July 1, 2021

• Aetna, Mednax stuck in contract dispute | Humana Foundation CEO resigns | Delta strain now most common | 25 healthiest communities | Conn. physician to pay $15M in billing case | Okla. 37th state to expand Medicaid

June 30, 2021

• Kaiser, Molina, HealthNet accused of running 'ghost networks' | Medicaid waiver puts $1.1B in limbo for Dallas hospitals | 5 top insurers: Forrester | Former CMMI chief starts healthcare venture | Anthem buys Puerto Rico's largest MA plan

June 29, 2021

• CMS pitches ACA enrollment, home health changes | Physicians trump Molina in court | 25 best places for healthcare access | UnitedHealthcare, Ga. hospital clash over contract | Why John Oliver is targeting cost-sharing ministries

June 25, 2021

• Biden eyes major Medicaid expansion, halts work rules in 2 states | UnitedHealthcare, Calif. physicians at odds over COVID-19 test payments | Aetna-Optum 'dummy code' lawsuit revived | Zing to acquire Pa. insurer

June 24, 2021

• Mass. insurer threatens Aduhelm coverage | Cigna to give members $500 to switch drugs | Mo. Medicaid expansion struck down | COVID-19 hotspots emerge | Humana expands in NC | Express Scripts sues US for $43M

June 23, 2021

• UnitedHealth to bring workers back to office | Humana updates imaging policy | Mayo physician fired after penning book with confidential info | Centene's 2nd HQ: 6 updates | Glassdoor names 17 healthcare cos. best places to work

June 22, 2021

• SCOTUS snubs insurers' ACA reimbursement case | RI hospital may lose accreditation | HCA trauma fees 10x higher than some rivals | How members ranked 9 Medicare Advantage plans | Why some pharmacies don't take insurance

June 18, 2021

• 7 Fortune 500 payers, ranked by members | Vaccines vs. CDC's 5 variants of concern | BCBS of Minn. names 1st CXO | What to know about Anthem's PBM

June 17, 2021

• ACA lives | BCBS Association, UnitedHealth end trademark feud | 1B CVS Health records exposed | NC providers declare mental health state of emergency | Brain cancer drug pulled from Medicare Part D

June 16, 2021

• Anthem joins generic drug project Civica Rx | Calif. lawmakers allege 'hostile management' at HCA hospital | UnitedHealth: $320B savings possible in next decade with lower ED visits | 14 top-rated healthcare CEOs on Glassdoor

June 15, 2021

• Permanent Medicare telehealth coverage: Where lawmakers stand | Ga. system, UnitedHealthcare hit contract impasse | Best children's hospitals: US News | Former Cigna exec launches Medicare Advantage-focused co.

June 11, 2021

• Hospitals to UnitedHealthcare: End, don't delay, ER policy | CDC calls emergency meeting | CEO pay at 5 top health insurers | 17 states without surprise billing protections | What new Alzheimer's drug could cost Medicare patients

June 10, 2021

• UnitedHealthcare delays ER policy | HHS to payers: No bills for COVID-19 vaccine | Rural hospitals may get paid to become ERs | Medicare, BCBS dangle vaccine incentives | Cleveland Clinic, Aetna + others launch blockchain firm

June 9, 2021

• UnitedHealthcare's ER policy ignites hospital backlash | Nurse bullying persists | Humana sued over data breach | Excellus BCBS CEO: Listen to providers | 20 'smartest' hospitals | La. bans 'white bagging'

June 8, 2021

• ER care target of latest UnitedHealthcare policy | CMS probes Mich. hospital | Biogen working with Cigna, CVS on Alzheimer's treatment | Walmart to expand virtual care into 16 more states| OptumCare: 4 things to know

June 4, 2021

• Renown, UnitedHealthcare terminate contract | Where 'payviders' are likely to succeed | Walmart prefers these 17 systems | Sentara, Cone nix merger | BCBS of NJ director: The 'fragility' of fee-for-service

June 3, 2021

• UnitedHealth sued over COVID-19 test payments | CMS chief outlines insurance priorities | 1 in 3 hospitals see denial rates in 'danger zone' | Viewpoint: Don't lift COVID-19 cost waivers | 8 insurers in this year's Fortune 500

June 2, 2021

• AHIP gets new look, mission | Cigna, Mary Washington break leaves 15,000 patients in limbo | Supreme Court's ACA ruling looms | Texas hospital eases masking | 10 best, worst states for healthcare of people 65+

June 1, 2021

• Biden leaves public option out of $6T budget | 15 top-paid healthcare CEOs: WSJ | Fear of surprise bills can fuel vaccine hesitancy | 8 healthcare lawsuits, settlements | CareSource offers cash for full COVID-19 vaccination

May 28, 2021

• Insurer says policy doesn't cover Carilion's $150M in COVID-19 losses | CMS to delay part of controversial Medicaid drug rule | 15 leaders join HHS | Piedmont offers nurses $30K sign-on bonus | 20 payer exec moves

May 27, 2021

• Texas NP used physician IDs to defraud insurers | Suicide attempts put Children's Colo. in state of emergency | Jefferson on track to fully own Pa. insurer | Lawmakers eye public option | 15 insurers members like the most

May 26, 2021

• Insurers sue CVS over drug prices | Va. system, Cigna at contract impasse | HHS allots $4.8B to test uninsured for COVID-19 | 10 financially strong systems | IRS issues COBRA guidance | Google, HCA partner

May 25, 2021

• Brooks-LaSure confirmed as CMS chief | States ranked by preventable hospitalizations | Next Gen ACO model to end | Tenn. to intervene in Medicaid waiver case | Anthem received millions in overpayments: OIG

May 21, 2021

• UnitedHealthcare, Montefiore split nears 6th month | Ill. hospital gets new trial in $20M Humana dispute | Colo. will pay hospitals to close freestanding ERs | Kan. tosses 'junk insurance' bill | What's 'COVID arm'? 7 findings

May 20, 2021

• Centene CEO wants to leave Mo. | Failed NY insurer gets $220M settlement from US | JPMorgan launches health co. | Texas to reapply for Medicaid waiver | Tufts-Harvard Pilgrim gets CEO

May 19, 2021

• Wis. employers swap UnitedHealthcare for network vowing 15% lower costs | Va. physician gets 59 years in prison for $20M fraud | SCA fires back at DOJ in collusion case | Anthem, Epic go in on data sharing with providers

May 18, 2021

• Aetna investigates potential 'waste, fraud' at Texas hospital | CMS further delays breakthrough tech rule | Nurses 'outraged' over new mask guidance | Back to office for most Humana workers | 10 healthcare lawsuits, settlements

May 14, 2021

• Hospitals adding payer performance officers to C-suite | 10 US counties where COVID-19 hospitalizations rising fastest | Miss. next target for Medicaid expansion | Oscar loses $87M in Q1 | Fortune's 8 greatest healthcare leaders

May 13, 2021

• Mo. withdraws Medicaid expansion | Where hospitals are best, worst at avoiding overuse | Cigna CEO unloads $16M in stock | Centene, Magellan deal nearly done | UnitedHealth, CVS among world's 20 largest healthcare cos.

May 12, 2021

• Saint Francis CEO blames BCBS break on last-minute term changes | Hospitals with more privately insured have better quality: study | U of Miami to settle false billing case for $22M | Ex-nursing aide sentenced for 8 patient deaths

May 11, 2021

• UnitedHealth, Cigna chiefs see pandemic's negative effects fading | UMass Memorial debuts insurance co. | Payer shares hit all-time highs | ProMedica insurer sues Ohio over managed Medicaid bids | Why several states are investigating PBMs

May 7, 2021

• CMS ups antibody infusion payments | Hospitals get slap on wrist for price transparency failures | 5M Americans enrolled in Medicaid during pandemic, study finds | Walmart to bring telehealth nationwide

May 6, 2021

• How CMS starred US News' 20 Honor Roll hospitals | UnitedHealthcare launches post-discharge program | What put Mission Health's Medicare contract at risk? | 1 in 6 workers stay at job for health insurance

May 5, 2021

• Physicians want insurers to pay for COVID-19 gear in Calif. | Saint Francis, BCBS of Okla. negotiations stall | CMS' direct contracting model: 53 participants to know | Medicare spending goes up when physicians join hospitals: study

May 4, 2021

• UnitedHealthcare, Renown hit contract impasse | BCBS Assoc. cuts revenue rule that hampered competition | HHS to pay vaccine fees not covered by insurers | 10 hospitals that best avoid unnecessary care

April 30, 2021

• CMS finalizes rules for CJR, marketplace plans | Judge throws out $8B Ky. Medicaid contracts | 199 hospitals with 1 star from CMS | Corporate America warms up to govn't healthcare | 25 payer exec moves

April 29, 2021

• Parents on their kids' health plans? Calif. considers it | Fla. sues HHS for $97M in payments | All 455 of CMS' newly 5-starred hospitals | Anthem buys nursing co. | Texas lawmakers want Medicaid waiver back

April 28, 2021

• Medicare expansion could be win for employers | Humana's $5.7B home health deal: 5 details | CMS floats inpatient payment rule | Out-of-network bills more common for labs | BCBS Assoc. beats cancer coverage lawsuit

April 27, 2021

• Insurers lift COVID-19 cost waivers | 4 healthcare execs sentenced in Medicare billing fraud | Revoked Medicaid waiver credit negative for Texas hospitals | IBM/Fortune's top 115 hospitals, health systems

April 23, 2021

• Optum's plan to become a $100B giant + 10 notes on its growth | NC system sues insurer over $1.5B payout | UnitedHealthcare, Anthem + 4 payers expanding digital health strategies | Cigna to sell Texas Medicaid plans

April 22, 2021

• 5 CMS payment models under review, delayed | Feds oppose new health plans tracking internet use | Telehealth services BCBS is keeping | Why 45 execs left Amazon | Meet Novant's 1st chief of payer performance

April 21, 2021

• Biden's pick to lead CMS on hold | Cigna accuses Conn. provider of price gouging | Highmark, ChristianaCare strike 10-year JV | 18 highest-paid healthcare CEOs | Oscar debuts tech business

April 20, 2021

• Stanford Health sues Anthem | Humana overcharged Medicare $200M: OIG | Billions in Texas Medicaid funding rescinded | 10 top-earning states for physicians | Optum takes telehealth nationwide

April 16, 2021

• Optum on track to hire 10,000 physicians by 2022 | JPMorgan stacking healthcare talent | Oscar names medical group leader; UPMC Health Plan taps 4 execs | Salaries for 29 physician specialties, ranked | Who's afraid of the virtual care boom?

April 15, 2021

• UnitedHealth sees nearly $5B profit | CDC shares data on COVID-19 cases among fully vaccinated | 6 BCBSA execs to know | CMS bans codes hospitals use to hide prices in web search

April 14, 2021

• NJ lab hits back in Cigna payment case | 9 hospital layoffs | Northwell taps Aetna exec as COO of direct contracting | Ill. extends Medicaid coverage for new moms | BCBS of Minn. parent to sell HSA unit

April 13, 2021

• BCBS of Mass. accused of allowing systematic overpayments | How states, pharmacies are handling J&J vaccine pause | 9 best systems to work for, per Fortune | Anthem to give employees COVID-19 vaccine incentives

April 9, 2021

• CMS pitches 4 payment rules | Cigna, Oscar expand partnership | J&J vaccine shortage coming | 10 most common passwords | Anthem teams up with EHR startup | Cyberattack exposes data of 1.2M Health Net members

April 8, 2021

• CMS adds 24 codes for telehealth, proposes 2 payment rules | Nurse accuses Highmark of failing to pay OT | Hospital expenses per inpatient day, state by state | NJ hospital, Horizon BCBS end 6-year legal feud

April 7, 2021

• UnitedHealthcare gets new chief | UK variant now most common strain in US | Medicaid work rules pulled in Mich., Wis. | States ranked by hospital beds | Cigna offers some members debit cards to switch drugs

April 6, 2021

• States ranked by ER visits | Teva: Dismiss Humana MS drug case | 33 billionaires in US healthcare | Aetna to run Ohio Medicaid program for kids | How many Medicare Advantage lives 15 payers added this year

April 2, 2021

• Anesthesiologists: UnitedHealthcare squeezes competition like a 'boa constrictor' | CDC clears travel for fully vaccinated | OIG: HCA hospital received $23M in overpayments | CMS recouping advanced Medicare payments

April 1, 2021

• CVS expects 65 billion healthcare interactions by 2030 | Mass. insurer exits commercial business | LA hospital closes | Wis. physician admits to $26M billing fraud | 30 payer exec moves

March 31, 2021

• BCBS of Minn. CEO Dr. Craig Samitt to retire | Medicaid changes make Biden's $2T infrastructure plan | 10 insurers ranked by share of Medicare Advantage | Miss. hospital overbilled Medicare, OIG says

March 30, 2021

• Holdout states reconsider Medicaid expansion | Hospitals admit more young adults for COVID-19 in Mich. | Humana reaches settlement in overtime wage case | Texas Health Aetna gets interim CEO

March 26, 2021

• Texas physician, clinic sued over alleged TRICARE fraud | Biden doubles vaccine goal | Bill delaying Medicare payment cuts passes Senate | Aetna names Calif. Medicaid CEO | 4 payer deals

March 25, 2021

• Va. system sues insurer | What payers learned from 1-year prior auth pilot | Humana-Epic partnership advances | Former hospice CEO pleads guilty to role in $60M scheme | How 5 BCBS cos. are helping distribute vaccines

March 24, 2021

• 10 payer CEO moves | Medicare rule will cut pay to hospitals for some surgeries | 13 indicted in Medicaid scheme | Cleveland Clinic, Anthem launch heart program for Eli Lilly employees | NY hospital mistakenly billed patients for COVID-19 tests

March 23, 2021

• 4 CMS payment models under review, delayed | Texas hospital execs sentenced in $200M scheme | Highmark records $1B net income | Humana CFO to exit | Sutter hospital fined after nurse's death

March 19, 2021

• 10 CMS actions | Mich. has epidemiologists concerned | Oscar exec joins board of Juul | 5 things to know about HHS' new leader | Cigna to open health center in Ariz.

March 19, 2021

• 10 CMS actions | Mich. has epidemiologists concerned | Oscar exec joins board of Juul | 5 things to know about HHS' new leader | Cigna to open health center in Ariz.

March 18, 2021

• Biden unwinds Medicaid work rules | CMS pulls coverage for 4 telehealth services | UnitedHealthcare restores free access to some claims data | New 'Medicare for All' bill: 4 notes

March 17, 2021

• CMS delays breakthrough tech rule, seeks apps for primary care model | Insurance telemarketers fined record $225M | 5 fast Medicare Advantage facts | NY targets hospital claim denials | 10 top healthcare cos. for innovation

March 16, 2021

• Aetna can't seek alleged hospital overpayments in Mednax case | MDLive, telehealth: What Cigna's Evernorth COO envisions | Fortune: 30 best healthcare employers | Who's up for vaccination in each state

March 12, 2021

• Centene sued over Ohio Medicaid costs | Biden: Vaccines need to open for all by May | CMS finalizes participants for emergency care model | Amazon to open health centers in 5 states | What 5,050 CEOs expect this year

March 11, 2021

• UnitedHealth, others used 'no-poach' agreements for senior execs: lawsuit | 13 payer exec moves | SCOTUS nixes Medicaid work rules hearing | 'Ticking time bomb' could invalidate thousands of health regs

March 10, 2021

• Hospitals target payers' drug policies | CDC's new COVID-19 guidance: 4 notes | 99K members' info. exposed in 2 health plan breaches | CMS delays kidney care model | BCBS of Minn. sues Martin Shkreli

March 9, 2021

• Hospitals target payers' drug policies | CDC's new COVID-19 guidance: 4 notes | 99K members' info. exposed in 2 health plan breaches | CMS delays kidney care model | BCBS of Minn. sues Martin Shkreli

March 4, 2021

• Aetna accuses Mednax of destroying evidence in overbilling case | 100 top critical access hospitals | 2 tools UnitedHealthcare will keep after pandemic | 3 updates on health insurance CEO pay

March 3, 2021

• White House to work with insurers on vaccine distribution | Optum to acquire Mass. physician group | BCBS of NC's pandemic claim costs: $200M | Tenn. hospital abruptly closes | Oscar shares start trading

March 2, 2021

• Highmark becomes 4th largest Blue plan; inks 6-year deal with Verily | CMS reviewing new payment model | Cigna to NJ court: End lab's lawsuit over COVID-19 payments | Centene makes 4 leadership changes

February 25, 2021

• Cigna, Centene CEOs among most 'overpaid,' shareholder advocacy group says | HHS suggests targeted reviews into potential upcoding | Father-son duo sentenced in national ACA insurance scam | 23 payer exec moves

February 24, 2021

• Aetna protests Okla. Medicaid picks | Highmark, HealthNow New York get approval for affiliation | Top CHS execs get raises | W.Va. hospital settles improper billing case | 6 payers among Forbes' best large employers

February 23, 2021

• Payer exec compensation: 5 notes | Molina CFO retires | Woman dies after contracting COVID-19 from donor lungs | Horizon BCBS issues nearly $50M in rebates | 27 Fortune 500 healthcare cos. recognized for equality

February 18, 2021

• CVS to reduce office space 30% | Biden picks CMS chief | BCBS of RI, hospital partner on readmission program | Texas hospitals face water problems | Former Ford, J&J execs join Humana's board

February 17, 2021

• BCBS of SC to add 700+ jobs | Biden's town hall: 5 healthcare notes | Dialysis co. hit with false claims suit | Humana to pilot new chronic care program | How Anthem, Cigna & 3 others performed in Q4

February 16, 2021

• Former Aetna exec sued over move to Cigna | Biden fills out HHS | Blue Shield of Calif. to use equity-focused algorithm in vaccine distribution | Michael Jordan gives $10M to open clinics in NC

February 11, 2021

• 22 states with reimbursement provisions for telehealth | CDC: Fully vaccinated people can skip quarantine | Healthgrades' 50 top hospitals | Medicaid expansions added to COVID-19 relief bill | 9 payer exec moves

February 10, 2021

• Centene to reduce workforce by 3,000 | CDC refines mask guidance | How big is Optum? 11 numbers to know | Proposed ACA changes in COVID-19 relief bill: 5 notes | 10 healthiest, unhealthiest cities

February 9, 2021

• UnitedHealth policies need fed'l review, hospitals say | CEO sentenced for $150M healthcare fraud | Humana, Roche settle lawsuit | Oscar's IPO: 3 notes | 33 healthcare cos. among 'world's most admired'

February 4, 2021

• UnitedHealth names CEO, COO | Former Mass. healthcare executive charged in $100M scheme | Front-runner emerges for CMS chief | More Medicare Advantage stars linked with better patient outcomes, study says

February 3, 2021

• Anthem's pharmacy revenues jumped in 2020 | COVID-19 deaths fall in 25 states | Who's who on Biden's healthcare team | Humana to join Cigna's GPO | Many patients spend half of yearly out-of-pocket tab in 1 visit

February 2, 2021

• Cigna ends prior auths for some CT scans | Optum erroneously billed patients for COVID-19 vaccine | Tufts-Harvard Pilgrim CEO to retire + 30 payer exec moves | UnitedHealth invests in Ill., La. housing

January 28, 2021

• Blue Shield to run Calif.'s COVID-19 vaccine rollout | Biden signs order on ACA, Medicaid | CMS withdraws 3 rules | Judge: UnitedHealth must redo 67K claims | 17 healthcare cos. with most remote jobs

January 27, 2021

• Humana to open 100+ Medicare centers by 2023 | UnitedHealthcare, anesthesia provider dispute leads to $15K bill | 2 dead in hostage situation at Texas medical office | Cigna CEO sells $12.7M in shares

January 26, 2021

• CEO of Intermountain's health plan resigns | Biden plans 3 healthcare actions this week | 45 employers join BCBSA's national network | 897 hospitals at risk of closing | WellCare pilots at-home COVID-19 tests

January 21, 2021

• Optum aims to add 10K physicians | Biden to sign 10 orders on COVID-19 | Cigna accused of using hospital surge to deny claims | 42 measures for Medicare Advantage, Part D star ratings

January 20, 2021

• UnitedHealth profits dampened by COVID-19 | Biden to sign 3 healthcare exec orders today | CMS should take action against 100 'error-prone' providers: OIG | Insurance broker helps erase $2M in medical debt

January 19, 2021

• FTC orders 6 payers to hand over data for study | UnitedHealthcare launches virtual primary care service | Excellus BCBS settles data breach affecting 9.3M | 14 recent CMS actions to know

January 14, 2021

• Phishing attack hits Minn. payer | Cigna wins $5.8M in false claims case | State strategies from the most successful vaccine rollouts | OptumRx opens pharmacy in NC | 13 payer exec moves

January 13, 2021

• CMS issues final rule for breakthrough tech: 5 notes | Cigna suspends some donations to lawmakers | Healthcare's 14 highest-paying jobs + 18 best places to work | UnitedHealthcare invests in Minn. housing

January 12, 2021

• Optum moves to buy 715-physician group in Mass. | UnitedHealthcare suspends some prior auth rules | Trump administration changes nat'l vaccine guidelines | BCBS Association suspends some political donations after Capitol riot

January 7, 2021

• CMS payment change for COVID-19 tests takes effect | Highest COVID-19 infection rates in world are in 3 states | 9 payer deals | Patients would pay $2,607 more for hospital with extra quality star | 5 top insurers, ranked by customers

January 6, 2021

• UnitedHealth's Optum to buy Change Healthcare in $13B deal | COVID-19 hospitalizations flare in South, West | Providers favored in arbitration decisions, study says | CEO of inpatient center admits to Medicaid billing fraud

January 5, 2021

• UnitedHealthcare, Envision sever ties | Aetna gets partial win in cancer coverage case | Tufts Health Plan, Harvard Pilgrim merge | Cigna sells $6.3B nomedical unit | Centene to buy Magellan

December 31, 2020

• Aetna pharmacy change affects 400K Ill. Medicaid members | COVID-19 variant found in 2nd state | Centene buys Pantherx | Record number of US workers calling in sick | 10 top payer stories this year

December 30, 2020

• ProMedica blocked from ending insurance contracts | Hospitals must release payer negotiated rates | Biden expands COVID-19 response team | 29 payer exec moves | Montefiore, UnitedHealthcare hit impasse

December 29, 2020

• Prime mailing error exposes data of Boeing health plan members | Duke, Geisinger sue HHS over Medicare payments | New to patients' paperwork: Binding arbitration agreements | BCBS of KC unit buys stake in value-based care co.

December 24, 2020

• 485K+ Aetna, Blue Cross members affected by data breach | Horizon can restructure | COVID-19 data will wobble for next 10+ days: 5 notes | Trump commutes sentence for Fla. healthcare exec convicted of Medicare fraud

December 23, 2020

• CMS issues final rule on value-based drug purchasing | Hospital staff reject COVID-19 vaccine | Trump wants changes to relief bill | Ambulances exempt from surprise-billing fix | 3 payers that launched virtual plans

December 22, 2020

• Calif. payer files for bankruptcy | Aetna sued over denied cancer therapy coverage | Fed'l COVID-19 relief: 10 notes | Texas hospital settles false claims suit for $48M | Oscar preps IPO

December 17, 2020

• UnitedHealthcare, Intermountain launch ACO | COVID-19 hospitalizations triple Sept. numbers | Haven exec leaves for BCBS of Mass. | Home health owners charged in $10M billing scam | Highmark, Google Cloud sign 6-year deal

December 16, 2020

• 65K members in limbo as BCBS of Texas, CHI St. Luke's split | Healthiest, unhealthiest states | Mass. physician accused of $10.6M billing fraud | 21 payer exec moves | Centene to buy pharmacy

December 15, 2020

• Tufts sells health plan to proceed with merger | US COVID-19 deaths hit 300K | Leapfrog's 'F,' straight-'A' hospitals | BCBS of Mich. to open 6 clinics | Humana co-founder dies of COVID-19

December 10, 2020

• Cigna shuffles leadership | Calif. suspends Medicaid payments to Borrego after FBI raid | 5 cities with highest ICU occupancy | Average cost of hospital COVID-19 tests by state | Humana expands primary care model

December 9, 2020

• 3 Bon Secours hospitals leave Anthem network | Most, least expensive states for ER visits | Kaiser tried to run insurance monopoly, Calif. system claims | Leapfrog's top 105 hospitals | Where employee insurance costs the least

December 8, 2020

• CMS delays cancer model, debuts direct contracting program | Biden picks HHS, CDC chiefs | US records most weekly COVID-19 deaths | Financial volatility ahead for payers | BCBS insurers' $2.7B antitrust settlement gets early OK

December 3, 2020

• Radiologists to Cigna: Revise hospital-based imaging policy | CMS releases outpatient payment rule | US daily COVID-19 cases near 200K | Oscar hires Capital One CFO | AHA: Prior auths, denials add to clinician burnout

December 2, 2020

• UnitedHealth expects $277B+ in revenue next year | CMS finalizes physician, telehealth payment rules | CDC panel: Vaccinate healthcare workers 1st | Optum CEO is back | 10 states with highest employee insurance costs

December 1, 2020

• NJ school board sues Horizon | Warp Speed leaders: COVID-19 vaccine to be widely available by June | Wash. fines insurance co. for selling illegal plans | 18 payer exec moves

November 25, 2020

• UnitedHealth delays lab coding changes | HCA defeats billing fraud suit | The CEOs of the 5 largest payers | Haven loses another exec | Harvard Pilgrim software issue caused breach

November 24, 2020

• Cigna intentionally blew up $48B Anthem deal, lawsuit claims | Where COVID-19 is spreading fastest, slowest | How WH's new drug-pricing rules affect insurers | CMS picks providers for primary care model

November 19, 2020

• BCBS of NC extends COVID-19 cost-sharing waivers | Texas physician sentenced for $17M billing fraud | Anthem Medicare members used 136x more virtual services | Medicare overpaid hospitals for defunct heart devices: OIG

November 18, 2020

• UnitedHealth: Move routine imaging out of hospitals, save 62% | US daily COVID-19 death toll highest since May | Healthcare exec pleads guilty to role in $1.2B Medicare scheme | Insurers: Providers inflate COVID-19 test prices

November 17, 2020

• Kaiser settles false claims suit | Amazon debuts online pharmacy | COVID-19 surges in 48 states; where spread is fastest, slowest | CMS sees fewer improper payments | Cigna's Evernorth: 5 notes

November 12, 2020

• Ohio hospital sues ProMedica over insurance agreement | COVID-19 hospitalizations rise for 18th day | Va. physician convicted on 52 charges in billing scheme | BCBS of Mich. partners with workplace healthcare provider

November 11, 2020

• UnitedHealth beats mental health denial lawsuit | NJ physician charged in $25M billing scheme | COVID-19 hospitalizations at all-time high | Aetna gets new lead | ACA at Supreme Court: 6 notes

November 10, 2020

• Cigna refused to cover COVID-19 testing, lawsuit alleges | Humana's CEO sells $30M in shares | CMS issues final Medicaid, CHIP rule | 5 things to know about CVS' new CEO

November 5, 2020

• UnitedHealth ordered to redo 67K mental health claims | Ex-Tenn. system CEO indicted for theft | 'COVID' fee showing up on medical bills | 5 recent CMS rules | Q3 results for Anthem, Cigna, Humana, UnitedHealth

November 4, 2020

• UnitedHealth illegally underpaid ER physicians: lawsuit | 146 telehealth services covered by Medicare during the pandemic | Ill. hospital tagged for erroneous billing | Physician who helped design Medicare dies

November 3, 2020

• 500+ BCBS of Mich. workers take buyouts | 39 hospitals face max readmission fines | Birx: US entering 'most deadly phase' of pandemic | 17 payer exec moves | Humana nearly doubles Q3 profit

October 29, 2020

• CMS pitches price disclosure, COVID-19 vaccine rules | Blue Cross Calif. fined over coverage delays | 3 insurers that laid off workers this year | Medicaid deals boost Molina's Q3

October 28, 2020

• Aetna settles 3 HIPAA breaches | CMS' Quality Payment Program results: 6 notes | Ballad to postpone elective procedures in Tenn. | Anthem profit tumbles 81% | Rapid COVID-19 tests coming to 1,000 CVS pharmacies

October 27, 2020

• Medicare, Medicaid to cover COVID-19 vaccine | ProMedica health plan to terminate Ohio hospital's in-network status | Intermountain, Sanford to merge | Centene's profit balloons to $568M

October 22, 2020

• CHI St. Luke's threatens split with Molina | Hospital chiefs warn of 'worse' COVID-19 wave as 16 states see record hospitalizations | CMS delays radiation oncology model | Humana updates musculoskeletal prior auths

October 21, 2020

• 4 healthcare execs charged in $55M billing scheme | UnitedHealth, Humana, Anthem, Cigna execs on telehealth strategy | Trump vs. Biden on healthcare: 8 notes | Mich. insurer to offer virtual-first plan

October 20, 2020

• How Anthem, Cigna, UnitedHealth's hospital-based imaging policies stack up | BCBS of Texas, CommonSpirit to split | Calif. systems refused, delayed COVID-19 transfers due to insurance | Best Medicare drug plans: US News

October 15, 2020

• CMS, BCBS expand telehealth coverage | Best Medicare Advantage plans: US News | 10 states with least competitive insurance markets | Optum physicians conduct 1M digital visits | 5 canceled hospital mergers

October 14, 2020

• UnitedHealth posts $3.2B profit | COVID-19 patient gets surprise $52K bill | Mo. hospital CEO put on leave | Humana adds 4 grocers to pharmacy network | Barrett: 'I am not hostile to ACA'

October 13, 2020

• Aetna, Premera cut jobs | 2021 Medicare plans with 5 stars | COVID-19 hospitalizations hit 6-week high | NC hospital gets 7 takeover bids | Highmark: Physician payment program saved $1B+

October 8, 2020

• Cigna targets hospital-based imaging | 4 physicians charged in $100M billing scheme | The VP debate: 6 takeaways | Patient shot at UCLA hospital | 10 cities with highest, lowest uninsured rate

October 7, 2020

• BCBS Assoc. has new CEO | Uninsured rates by state | Record COVID-19 hospitalizations hit 7 states | Citing CEO, physicians leave Kan. hospital | Op-ed: Some payment models maintain structural racism

October 6, 2020

• Walmart Health COO outlines insurance business | LA hospital can force Anthem to cover ER visits | Trump isolates in White House | How tenative $2.7B antitrust deal would change Blue operations

October 1, 2020

• Walmart launches 1st insurance plans | UnitedHealth, Anthem curb telehealth coverage | COVID-19 cases up in 25 states | Anthem settles 2015 cyberattack for $39.5M | 100 biggest US hospitals

September 30, 2020

• Baylor St. Luke's regains Medicare funding | 1st presidential debate: 7 notes | Fastest-growing healthcare jobs | BCBS of Ariz. CEO: Strengthen payer-hospital ties | 22 payer exec moves

September 29, 2020

• Aetna, Anthem, Cigna, Humana + UnitedHealth's virtual care strategies: 13 notes | Trump, Biden debate at Cleveland Clinic | NYC Health + Hospitals settles billing fraud suit | Molina to buy Medicaid insurer for $380M

September 24, 2020

• BCBS insurers reach tentative $2.7B deal in antitrust case | Trump preparing healthcare exec orders | Sam's Club launches $1 telehealth visits | CVS accused of patient steering

September 23, 2020

• Independence CEO to retire | UnitedHealth accused of illegally deflating payments | Medicare won't cover COVID-19 vaccines approved under emergency use authorization | 10 states where private insurers pay most, least relative to Medicare

September 22, 2020

• BCBS of Mich. offers 8,500+ workers buyouts | CDC reverses guidance on COVID-19 airborne spread | CMS: Vermont's all-payer model underperforming | BCBS Assoc. sues investment firm over $2B loss

September 17, 2020

• When telehealth cost-sharing waivers end for 5 payers | 3 notes on CMS' emergency care payment model | CVS doubles COVID-19 testing sites | 4 new hospital-insurer partnerships

September 16, 2020

• MedStar, CareFirst: New partnership to curb costs by $400M | Cigna rebrands health services unit | Physician shot outside Minn. hospital | States ranked by infant mortality rate | 4 insurers expanding ACA marketplace footprint

September 15, 2020

• CMS pitches Medicare Advantage + Part D changes, scraps Medicaid accountability rule | NJ's newest insurer run by Hackensack, RWJBarnabas, Horizon | Former military health director joins Humana's board | 10 ACOs with most shared savings

September 10, 2020

• Humana launches heart, shoulder payment models | Ill. nurse practitioner pleads guilty to Medicare fraud | 9 payer exec moves | Cigna expands to 80 counties | 8 hospital closures

September 9, 2020

• Cambia CEO to retire | Anthem, Calif. hospital clash over contract | Urgent care network settles billing fraud case | 8 fastest-growing healthcare jobs + wages | How US News' best hospitals for cancer care improve outcomes

September 8, 2020

• Physician quits over $11K COVID-19 test | Independence Blue Cross settles false claims allegations | Tyson Foods to pilot medical clinics | OIG tags Ariz. hospital for erroneous billing

September 3, 2020

• CMS' final inpatient rule for 2021: 7 things to know | TeamHealth: 127 affiliated physicians out of Centene's network | 50 states ranked from healthiest to unhealthiest | Dignity, Cigna reach agreement after 9 months

September 2, 2020

• 10 updates on payer-provider relationships | Humana partners with Salesforce | Conflict of interest claims dismissed in contested NC Medicaid bid | Mayo hits pause on luxury hotel

September 1, 2020

• CMS floats Medicare coverage of breakthrough tech | Aetna-CVS launch health plan | Anthem, Cigna won't get damages from failed deal | Pentagon to seek proposals for $58B Tricare contracts

August 27, 2020

• Chicago hospital may lose Medicare contract | CDC director walks back new COVID-19 testing guidelines | 24 payer exec moves | OIG: Medicare Advantage encounter data rarely complete

August 26, 2020

• Aetna fined for denying ER claims | Insurers' COVID-19 waivers to expire soon | Texas physician settles billing fraud allegations for $530K | Feds to hospitals: Report COVID-19 data or lose CMS payment

August 25, 2020

• Humana accuses telemed firm of fraud | BCBS of Tenn. threatens to sue data firm over provider overcharge report | States ranked by unemployment rate | Verily unveils subsidiary for stop-loss insurance

August 20, 2020

• Trump to insurers: Vow to expand telehealth benefits | Fla. hospital ends Medicare contract | 6 payer CEOs earning $15M+ | Top hospitals for patient experience by state | Jury: Centene underpaid TeamHealth

August 19, 2020

• Aetna, Cleveland Clinic partner | 5 notes on COVID-19 and the uninsured | 10 payers issuing premium credits | UnitedHealth: Global payments equal better outcomes

August 18, 2020

• CMS to up pay for COVID-19 care | US' 3rd-leading cause of death: COVID-19 | Anthem, Quest Diagnostics partner | Humana's antitrust claims against Mallinckrodt advance

August 13, 2020

• UnitedHealthcare to ditch paper checks | NJ lab sues Cigna over COVID-19 reimbursement | 85 hospitals with 1 star for patient experience | Cigna names CIO + 7 payer exec moves

August 12, 2020

• NM insurer to close | Humana director resigns | 266 hospitals with 5 stars for patient experience | CMS unveils rural hospital payment model, expands artificial heart coverage | 20 priciest drugs

August 11, 2020

• Lawmakers to probe health insurer profits | Anthem accuses former VP of soliciting employees, providers | Humana sues Teva over recalled blood pressure drugs | CVS HealthHub rollout resumes

August 6, 2020

• CMS to update star ratings | DOJ sues Cigna over Medicare billing | Fla. physician charged in $681M billing scheme | 10 best, worst states for healthcare | 3 health insurer CEOs: How COVID-19 changed payers

August 5, 2020

• States ranked by percent of Americans delaying care | Humana nearly doubles Q2 profit | CMS lets payers temporarily reduce premiums | Mo. to expand Medicaid | UnitedHealth: 7 steps to the 'next-generation health system'

August 4, 2020

• Mo. hospital loses Medicare contract | CMS pitches physician payment rule, releases Part D premiums | Trump's telehealth order calls for new payment model | NJ hospital error left patient with $1,980 bill

July 30, 2020

• Anthem doubles profit + 3 other payer Q2 results | US has new COVID-19 hot spot strategy | 15 top cities for healthcare jobs | Oscar launches $0 virtual primary care | 17 payer exec moves

July 28, 2020

• Anthem pays $27K medical bill after TV report | State COVID-19 rankings | 20 best hospitals + No.1 in each state, per US News | BCBS of Mass. ups child psychiatrist pay 50% | Centene triples operating earnings

July 23, 2020

• COVID-19 positivity, deaths + hospitalizations by state | Employers rank Cigna highest, UnitedHealth lowest on drive for value | Clover Health to triple footprint | 7 payer-provider disputes, resolutions | 10 states with most COVID-19 restrictions

July 21, 2020

• BCBS of NC: Pandemic costs top $600M | States ranked by COVID-19 positivity + spread rates | Who should pay for COVID-19 tests? Vague guidance creates confusion | Optum's revenue grows to $33B | Short-term health plans get court win

July 16, 2020

• States' uninsured rates | UnitedHealth earnings double; insurer accused of 'cross-plan offsetting' | US coronavirus death rates by state | BCBS of Mass. debuts primary care payment model | Hospitals overbilled Medicare $1B: OIG

July 14, 2020

• 5.4M Americans lost insurance during pandemic | States ranked by COVID-19 spread, test positivity rate | NJ hospitals: Insurers denied 1,000+ claims for COVID-19 care | Molina, UC San Diego split affects 9K | Healthcare billing co. hacked

July 9, 2020

• US COVID-19 cases jump 72% in 2 weeks | Medicare vs. private payers: How rates differ for 10 services | More health insurers selling dental plans | Humana to hire 200 | 15 cities with best healthcare access

July 7, 2020

• Insurers cutting telehealth coverage as COVID-19 cases surge | Walmart to launch insurance agency | Calif. surgeon charged in $600M billing scheme | CMS pitches dialysis payment rule: 5 notes | 14 health plan deals this year

July 2, 2020

• Payer execs: 5 ways COVID-19 will affect business | Ex-hospital exec charged in $1.4B billing scheme | 26 states with fastest, slowest COVID-19 spread | Centene to open 2nd HQ

June 30, 2020

• TeamHealth's racketeering suit against UnitedHealth advances | 5 states with most people delaying, returning to care | Humana to expand Walmart coronavirus test sites | Ex-Cigna exec: Canada does it better | 19 payer exec moves

June 25, 2020

• BCBSTX president out | US coronavirus cases hit all-time high | Physicians, payers contest prior auths | Anthem info now Alexa-accessible | BCBS of NC pays primary care clinics to stay open | 518+ telehealth, RCM companies to know

June 23, 2020

• 16 Optum execs to know | COVID-19 cases jump in 26 states | Blue Shield of Calif. debuts 20 pilot programs | White House set to ask SCOTUS to overturn ACA | Epic-Humana partnership 1 year later | CVS to open Aetna office, hire 500

June 18, 2020

• UnitedHealthcare CEO to lawmaker: 100,000+ physicians added to network in past year | CMS issues Medicaid drug pricing rule, opens LOIs for direct contracting | HCSC partners with Epic | 10 top Medicare Advantage plans

June 16, 2020

• Highmark, NY insurer to combine | HDHPs 'turned out to be bad,' physician survey says | COVID-19 activity by region | Medicare fraud settlements don't impede hospital relief funds | 10 top children's hospitals: US News

June 11, 2020

• Cigna accuses drugmakers of price fixing | Where COVID-19 cases rising, falling | Optum hires ex-BCBSNC CEO + 6 payer exec moves | FCC brings record $225M fine against health plan telemarketers | Medtech exec charged in $69M fraud scheme

June 9, 2020

• 6 specialties with most out-of-network bills | Anthem to give $2.5B to customers, providers | CMS testing guidelines for uninsured: 5 notes | Former Humana exec to become CEO of physician network firm | Pandemic will cost insurers $30B to $547B: report

June 4, 2020

• UnitedHealth to help build 1,000 more homes | States with fastest COVID-19 spread | CMS updates payment models: 5 notes | CEO pay for 20 big healthcare cos. | Humana unit to open 20 clinics

June 2, 2020

• UnitedHealth- Houston Methodist agreement official | Rise, fall of COVID-19 spread by region | BCBS of Ariz. launches hospital loan program | CMS' new rules for risk adjustment validation programs: 3 notes | Cigna extends COVID-19 cost relief

May 28, 2020

• Lawmaker questions UnitedHealth on network, reimbursement changes | 6 BCBS companies sue CVS, claiming decadelong fraud scheme | 5 payer exec moves | UnitedHealth, Anthem + 18 healthcare companies with biggest annual profits

May 26, 2020

• CMS expands telehealth, caps insulin costs | Highmark BCBS premium error sparks state action | 10 specialties that generate most revenue for hospitals | Houston Methodist returns to UnitedHealth network

May 21, 2020

• Cigna expands virtual provider network | Hospital expenses per visit, state by state | Humana strikes kidney care partnership | Big commercial plans rarely prefer biosimilars | Where UnitedHealth, Anthem & 5 others stocks stand

May 19, 2020

• 22 health plans members like the most | Premera Blue Cross debuts virtual care plan | 40 healthcare companies make Fortune 500 | Anthem, SmileDirectClub partner | Centene launches health disparities task force

May 14, 2020

• BCBS of Texas ordered to pay 2 hospitals $108M | AHIP to insurers: Extend prior auths for surgeries | 8 insurers offering member discounts | UnitedHealth to sell more ACA marketplace plans | How much childbirth costs vary across US

May 12, 2020

• Adventist-led proposal shifts billing to payers | CMS' proposed 2021 inpatient payment rule, final payment notice for ACA marketplace | Wash. physician settles false billing allegations | 10 payer therapy priorities | 4 insurers offering member discounts

May 5, 2020

• Humana waives all office, telehealth visit costs for 4.5M members | 43M could lose employer health insurance: study | Hospitals get help from insurers with strong finances | Billing confusion persists for presumptive COVID-19 cases

April 30, 2020

• 'Free' COVID-19 tests may come with catch | Mich. physician charged in billing scheme | Financial updates from Cigna, Anthem, Humana & Centene | Nat'l social distancing measures expire today | 16 payer exec moves

April 28, 2020

• Insurers extend prior auths for elective services | Optum in talks to acquire telehealth provider for $470M | Va. health system, physician group settle false billing claims | Hospitals, insurers call on Congress to protect health coverage

April 23, 2020

• Chicago psych hospital closes after losing Medicare contract | Coronavirus death rates by state | The 3-phase COVID-19 strategy BCBS of Minn. is using | CMS lifts freestanding ER billing restrictions

April 21, 2020

• UnitedHealth exec pay: 3 notes | Insurer premium rebates could hit $2.7B | Clinicians get MIPS credit for COVID-19 data | Contactless payments surge amid COVID-19 | HHS language signals surprise billing ban during pandemic

April 16, 2020

• UnitedHealth, Humana, other payers expand coverage to 250+ telehealth services | Optum CEO takes leave to help WHO vaccine effort | Texas hospital: Aetna owes $12M in unpaid claims | 5 payer exec moves

April 14, 2020

• CMS pitches 3 payment rules, delays emergency care model + releases cost-sharing rules | UnitedHealth earnings to shed first light on COVID-19 effects | Blue Shield of Calif. unit to acquire 2,700-physician group | Molina won't buy Medicaid plan

April 9, 2020

• UnitedHealth, CMS accelerate billions in provider payments | 9 national COVID-19 updates | UnitedHealth, Cigna accused of underpaying behavioral health claims | New COVID-19 peak dates in each state | Uninsured COVID-19 hospital costs could top $41B

April 7, 2020

• Final Medicare Advantage rates: 5 things to know | 6 national COVID-19 updates | Blue Shield of Calif. to help hospitals get cash | Premium increases likely as pandemic costs mount: analysis | State-by-state prediction of insurance losses due to COVID-19

April 2, 2020

• 13 insurers waiving costs for COVID-19 treatment | Anthem hit with federal lawsuit alleging Medicare fraud | US deaths jump 1K in 1 day | When will COVID-19 peak? A state-by-state analysis

March 31, 2020

• UnitedHealthcare delays new ED policy | CMS makes sweeping regulatory changes: 5 outbreak updates | Humana, Cigna waive costs for COVID-19 treatment | BCBS of North Carolina gets new CEO + 14 payer exec moves

March 26, 2020

• Aetna drops cost-sharing for COVID-19 hospitalizations | Insurers ditch prior auths, expand telehealth coverage | US coronavirus deaths pass 1,000 | Medicaid will cover $35k COVID-19 bill, uninsured woman hopes

March 24, 2020

• BCBS: Walgreens overcharges for drugs | NY to insurers: Free employed clinicians to fight pandemic | US coronavirus deaths jump 100+ | Centene CEO made $26M+ again | State rankings of COVID-19 risk, Medicaid coverage

March 19, 2020

• Coronavirus deaths by state as of 8 am CDT | US prepares for 18-month pandemic | The healthiest, unhealthiest county in each state | Highmark: Members 'returning home' after UPMC feud | 21 CMS coronavirus actions

March 17, 2020

• UnitedHealth to workers: Come on-site unless sick, high-risk | Miss. hospital owner convicted in $10M billing scheme | 8 facts about the world's last pandemic | Trump expands Medicare coverage for telehealth

March 12, 2020

• UnitedHealth split knocks US Anesthesia Partners' outlook | 150M Americans may get COVID-19, federal physician says | Direct Contracting payment models: 11 key dates | 9 payer exec moves | 50 patient safety experts to know

March 10, 2020

• BCBS of NC wins $9.4B contract | HHS finalizes interoperability rules | BCBS of Texas to reimburse ER claims, pay $10M fine | Cleveland Clinic + Oscar: 5 updates | 10 best hospitals in the world: Newsweek

March 5, 2020

• UnitedHealth, insurers gain $48B on Biden win | Humana launches payment model for SDOH | BCBS of NC net income falls $193M on 'record-high' expenses | CMS may pay hospitals for treating uninsured coronavirus patients

March 3, 2020

• BCBS owed $29M from bankrupt Texas system | UnitedHealth plan steers members to Optum physicians: 5 notes | Anthem buys Beacon | OIG tags CHI St. Vincent for improper billing | Amazon, Mich. insurer create storefront

February 27, 2020

• CMS revamps quality strategy | Fla. man with 'junk plan' owes thousands after hospital visit for coronavirus symptoms | 26 payer exec moves | 16 'overpaid' healthcare CEOs | Anthem makes AI investment

February 25, 2020

• Aetna draws criticism for automatic down-codes | UnitedHealth stock has worst day in 9 years | 25 hospital exec moves | Insurer clinics 'very worrisome for hospitals' | Mich. ACO exec sentenced for stealing Medicare bonus

February 20, 2020

• Trump commutes sentence for woman involved in $200M Medicare scheme | Pa. hospital cited over 2nd patient death | Amazon Care goes live | Humana targets provider directories | Medicare Advantage growth among biggest for-profit payers

February 18, 2020

• Optum beats UnitedHealthcare in profit | CEOs of 10 largest payers | Feds: Fla. physician bilked insurers $26M | Mass. hospital's faulty data slashed Medicare payments statewide | 100 CMOs to know

February 13, 2020

• BCBS of Tenn. pharmacy change draws physician backlash | Recession affected insurance CEO pay — here's how | 18 payer exec moves | Self-pay cheaper for childbirth, says woman who now goes uninsured

February 11, 2020

• Trump wants Medicaid, Medicare cuts | Horizon BCBS CEO steps back | Patients face 'retrospective denials': 4 notes | Cigna changes Express Scripts leadership | 7 updates on payer, provider relations

February 6, 2020

• CMS issues new rules for Medicare Advantage | Payers, hospitals set 2-day prior authorization limit | Telemedicine owners charged in $56M Medicare fraud scheme | Percent of federal funds that go to Medicaid in each state

February 4, 2020

• 10 biggest health insurers | CMS cuts payments to 786 hospitals | Walmart Health: 5 notes | Ex-Aetna CEO says he's being pushed off CVS board | 100 hospital CIOs to know

January 30, 2020

• CMS overhauls Medicaid funding | HCSC to lay off 400 | The 635 hospitals with most + fewest stars from CMS | 22 payer exec moves | Healthcare's top 10 billionaires

January 28, 2020

• Neb. surgeon lets patients pay by volunteering | Mont. hospital insurer once competed with BCBS — what happened? | Coronavirus death count 100+, cases near 5k | Healthcare CFO fired after questioning ambulance billing, suit says

January 23, 2020

• Trump 'going to look' at Medicare cuts | WellCare, Centene deal to close today | 7 things to know about the coronavirus outbreak | Advocate Aurora to partner with Wis. hospitals on Medicare product

January 21, 2020

• Medicaid block grant guidance coming | BCBS, Texas hospital must arbitrate $21M suit | Miss. hospital sued over failure to pay for employees' insurance | State: Ohio Medicaid dropped 272 pharmacies because of Walgreens, CVS

January 16, 2020

• Ex-Cigna exec: I regret making coverage 'choice' a talking point | Not a MinuteClinic: UnitedHealth exec outlines Walgreens sites | CVS to add 600 HealthHUBs, link them to lower Aetna copays | Insurers to SCOTUS: Review ACA case

January 14, 2020

• Cigna partners with Oscar | Physician, salesperson charged in $12M fraud scheme against insurer | Next Gen ACOs aren't lowering hospital spend | 4 NY hospital execs on what 'Medicare for All' would mean for them

January 9, 2020

• Houston Methodist ad: UnitedHealth members still have 'out-of-network benefits' | 50 states of healthcare affordability | Ind. health system accused of Medicare fraud | BCBS of Minn. CEO: Look to incumbents for reinvention

January 7, 2020

• CMS proposes risk adjustment updates to Medicare Advantage | 2 Calif. physicians settle billing fraud allegations | Oscar Health drops Walgreens from network | Steward Health sells health plan | Molina to acquire Ill. Medicaid plan for $50M

January 2, 2020

• UnitedHealth-Houston Memorial split affects 100,000 | Healthcare exec sentenced for role in $450M billing scheme | UnitedHealth shares worth 10 times more today than in 2010 | Hospital acquisitions may hurt patient experience

December 31, 2019

• BCBS of Tenn. specialty drug change prompts backlash | UnitedHealth stock gets year-end boost, but what's ahead? | AHA largely silent on suing patients for unpaid bills | The decade in healthcare: 12 milestones

December 24, 2019

• HCSC issues layoffs | TeamHealth's ER billing scrutinized at Nashville General | Aetna, Cigna, BCBS fined over improper denials | 100 hospitals with great orthopedic programs

December 19, 2019

• Cigna sells group insurance unit for $6.3B | Ex-UnitedHealth CEO's startup tops $1B in funding | ACA mandate ruled unconstitutional | Nonprofit health plans sue Texas over $10B Medicaid contracts

December 17, 2019

• NY physician sentenced in $30M billing scheme | HHS appeals termination of hospital outpatient pay cut | Memorial Hermann, Cigna to end contract | ACA taxes face repeal in $1.3T spending deal

December 12, 2019

• UnitedHealth: 50 states, ranked by health | BCBS of Mass. integrates with PillPack | Why Anthem doesn't want to own physician practices | Best places to work in healthcare: Glassdoor

December 10, 2019

• UnitedHealth to buy pharmacy | Humana execs offload shares | $12B ACA case before SCOTUS | Dignity, Cigna hit contract gridlock | BCBS of RI debuts 1st outpatient joint bundles

December 5, 2019

• Anthem payments can't keep up with costs, Ky. hospital CEO says | 4 things to know about Optum's 'city by city' strategy | BCBS: Tenn. hospital used 'suspicious' billing tactics | Hospitals sue to block price transparency rule

December 3, 2019

• UnitedHealth: 2020 revenues to top $260B | Highmark CEO to chair BCBSA board | Booker: Payers must fix bias in algorithms | Mich. insurer alerts members of phishing attack

December 2, 2019

• Best Buy's healthcare strategy: Get insurers to pay | Anthem racks up fines in Calif. | Boston Heart resolves kickback claims | CVS to buy Centene plan | OIG: Medicare overpaid hospitals $502M

November 27, 2019

• CMS opens primary care model applications | Calif. surgeon sentenced in $580M billing scheme | UnitedHealth: 10 updates | BCBS of Mass. expands digital therapy offering

November 26, 2019

• Florida Blue threatens to remove hospital chain from network | Aetna may sell workers' comp unit | US sees earliest flu season in decade | 23 exec moves | Errors riddle new $11M Medicare cost tool

November 25, 2019

• UnitedHealth Medicare centers coming to Walgreens | 29 best-managed healthcare companies | SF hospital failed CMS reinspection after patient abuse scandal | ProMedica stops Medicaid enrollment

November 21, 2019

• Walmart to use UnitedHealth services in telehealth pilot | 10 states with highest deductibles | Humana saved $3.5B under programs that lowered hospital use | Seattle Children's knew of mold issues last year, emails say

November 20, 2019

• Anthem sues for $100M in federal payments | Seattle Children's CEO discloses 6 patient deaths linked to mold | Medicare improper payments down $7B | CMS withdraws Medicaid block grant guidance

November 19, 2019

• Payer stocks rally as 'Medicare for All' threat wanes | BCBS bets $20M on digital health management startup | Ex-CEO faces 20-year Medicare ban for billing fraud | 10 payer exec moves

November 18, 2019

• BCBSA's new national network: 4 notes | CMS finalizes price transparency rule, targets Medicare Advantage overcharges | HealthPartners cuts 75 jobs as Medicare revenue declines | Harvard Pilgrim's net income falls more than 50%

November 14, 2019

• Steward Health to spin off health plan | MD Anderson: Patient CMS reported dead is still alive | Humana partners with another EHR | Medicaid providers may face new reporting rules

November 13, 2019

• BCBSNC adds Atrium, Novant to risk-based network | KKR wants to buy Walgreens | Ore. insurer barred from expanding into Portland | CareFirst BCBS defrauded by broker

November 12, 2019

• UnitedHealth picks Optum CEO as president | Hospitals overbilled Medicare $54M for patient transfers, OIG finds | Average hospital expenses per inpatient day across 50 states | Florida Blue alerts members of data breach

November 11, 2019

• UnitedHealth sued again over mental health coverage | Kaiser Permanente CEO dies | BCBS of Ill. begins Chicago expansion | Banner-University Health Plans CEO: 360-degree view of patient possible with new tool

November 7, 2019

• 10 cities with highest, lowest uninsured rates | HealthPartners to lay off 300 | Humana's job cuts to cost $46M | Payers aren't on 'dark side' — great care needs strong payer-provider relationships

November 6, 2019

• Fla. safety-net system bets on upgrades to lure insured | Kaiser CEO: Warren's 'Medicare for All' plan would mean layoffs | Aetna boosts CVS Q3 profit by 10% | CMS finalizes home health, kidney payment rules: 14 notes

November 5, 2019

• UnitedHealth expands housing program | CMS: Serious deficiencies found at MD Anderson | Kaiser health plan can't stop Hawaii system from balance billing | Ind. suspends Medicaid work rules

November 4, 2019

• Haven tests health plan | 9 notes on CMS' final outpatient, physician payment rules | Warren's 'Medicare for All' funding plan: 8 takeaways | Resignation of BCBS of NC CEO was 'wrong message' on mental health: viewpoint

October 31, 2019

• Molina loses Texas Medicaid contract | Iowa physician accused of filing 89 fraudulent Medicare, Medicaid claims | 15 payer exec moves | Cigna, WellCare see profits balloon

October 30, 2019

• Insurers denied physician career-saving treatment, lawsuit says | 1,500+ hospitals to see payment boosts under VBP program | Walgreens to close 160 in-store clinics | Molina's profits slip

October 29, 2019

• Humana to lay off 800+ workers | Mastercard eyes payers in new healthcare push | UnitedHealth helps lift S&P 500 to record high | Blue Shield partners with Dignity, startup for billing pilot

October 28, 2019

• Ore. insurer accuses 3 health systems of antitrust activity | CMS delays primary care model | Texas Health Aetna CEO departs | Chargemasters shouldn't be linked to Medicare payments, 5 systems say

October 24, 2019

• GOP's ACA replacement plan: 5 notes | Insurance exec sentenced for defrauding Pa. hospitals | Amazon buys healthcare co. for primary care line | Ga. health system pays out-of-network costs after Anthem dispute

October 23, 2019

• Anthem, Centene profits surge | UnitedHealth drops appeal of SCOTUS decision on alleged overpayments | 10 'best hospital cities' | Public option may lower commercial premiums, study finds

October 22, 2019

• FTC orders 5 major payers to turn over claims data | Humana sues 37 drugmakers | CMS loses bid to preserve site-neutral pay cuts | UnitedHealth defeated in 2 major contracts for retirees

October 21, 2019

• UnitedHealthcare to limit hospitals' outpatient surgery payments | Humana partners with Microsoft | Whistleblower: Seattle payer bilked millions from Medicare | NJ officials reject Horizon's claims review policy

October 17, 2019

• Optum, UnitedHealth offer care + coverage with new package | US News: Best Medicare Advantage, Part D plans | Humana director resigns | Molina to buy NY Medicaid plan

October 16, 2019

• CMS sanctions UnitedHealthcare plan | Tenet spends $630K to derail 'Medicare for All' | Amazon pays for employees to travel for cancer care | CareFirst BCBS partners with DC incubator

October 15, 2019

• 10 states with the highest, lowest uninsured rates | UnitedHealth posts $5B profit | CMO: Cigna may force Mass. hospital out of network | Nearly all of HCSC's highest-paying execs got raises in 2018: report

October 14, 2019

• The 2020 Medicare plans with 5 stars + 5 plans flagged for low ratings | BCBS of NC updates protocols, officially ends Cambia talks post-CEO scandal | ACA ruling expected this month | Cleveland Clinic, Oscar expand co-health plan

October 10, 2019

• CMS to investigate NJ hospital after ProPublica exposé | New York BCBS plans allegedly overpaid hospitals $85M | UnitedHealth to kick off Q3 results next week: 4 notes | 3 infants die of bacterial infections at Geisinger's NICU

October 9, 2019

• BCBS of Texas debuts first of 10 primary care clinics | Ex-BCBS of NC CEO found guilty of DWI, child abuse | Michigan's Medicaid program may fire its PBMs | Humana shakes up C-suite responsibilities

October 8, 2019

• Humana: 25% of healthcare spending is waste | Calif. physicians, medical group CEO settle billing fraud case | Medicare may overpay hospitals $1B for graduate studies every year | WVU Medicine unveils Medicare Advantage plan

October 7, 2019

• Trump rule would make immigrant visas contingent on health insurance | CMS terminates Ill. hospital's Medicare contract | UnitedHealth buys Va. health plan; issues layoffs in Minn. | Surgeon settles false billing allegations for $4.25M

October 3, 2019

• Trump signs executive order on Medicare | Ex-Capital One president joins Anthem's board | 56 hospitals facing maximum Medicare readmission penalties | Tenn. hospitals address proposed Medicaid block grant

October 2, 2019

• BCBS of NC needs to rebuild trust — analysts say it won't be easy | 14 hospitals with the most ER visits | UnitedHealth, Humana downgraded on election uncertainty; Cigna gets boost | Ex-hospital CEO charged in $114M billing scheme

October 1, 2019

• Cambia, BCBS of NC call off deal | CMS penalizes 2,583 hospitals for readmissions | 19 payer exec moves + 20 insurers expanding Medicare Advantage products | WellCare to sell Medicaid plans to Anthem

September 30, 2019

• UnitedHealth stock faces biggest quarterly drop in 9 years | Hospitals slam CMS' move to disclose negotiated payer rates | Feds charge physicians, healthcare execs in $675M billing fraud bust | Regence BlueShield to unveil surprise-billing legislation

September 26, 2019

• UnitedHealth mailed woman 500 denials in 5 days, she says | BCBS of NC CEO resigns | Cost of employer-based health coverage hits new record for families | Ark. hospital hopes nonprofit status will boost Medicare reimbursement

September 25, 2019

• BCBS of NC halts merger plans as details of CEO's arrest emerge | Blame insurers for surprise medical bills, TeamHealth exec says | Medicare billing error affects 411,000 seniors | Verma to payers: Listen to patients, or go extinct

September 24, 2019

• Humana sets up digital shop in Boston | Walmart's plan to build a healthcare workforce: 5 things to know | CMS finalizes Medicaid DSH payment rule | Why Anthem is a 2nd or 3rd choice for investors

September 23, 2019

• BCBS of NC CEO arrested after car crash | 79 best-ranked health plans | $258M fraud bust brings charges to 17 medical professionals | Humana CEO: Competition, innovation key to lowering drug prices

September 19, 2019

• 10 states with least competitive insurance markets | Centene, WellCare clinch major regulatory win | Former Texas hospital exec imprisoned for $16M Medicare fraud | Tenn. unveils Medicaid overhaul

September 18, 2019

• General Motors cut health insurance for 50,000 employees | Humana co-founder, longtime CEO dies | Oscar taps former Uber exec as COO | UnitedHealth sued again over mental health claims

September 17, 2019

• Whole Foods axing health plans for 2,000 workers | Anthem: 10 updates | Ohio hospital employee dies after man drives truck into ER | 5 payer lawsuits | BCBS of NC debuts drug savings program

September 16, 2019

• UnitedHealth buys Equian | Mass. hospital president: BCBS putting profits over patients | NJ physician pleads guilty in $1.2B fraud scheme | 9 states + DC with lowest uninsured rates

September 12, 2019

• 10 states with highest uninsured rates | Calif. provider charged in $115M Medicare fraud scheme | Nurse sues Tenn. hospital over patient attack | Meet UnitedHealth accelerator's 10 inaugural startups

September 11, 2019

• UnitedHealth's revenues head toward $275B: analysts | UPMC board faces criticism for silence on Highmark feud | Humana deploys robots to coach empathy | Why payers may be fueling ransomware attacks

September 10, 2019

• Healthcare exec accused of falsely billing BCBS | 10 updates on UnitedHealth | Anthem restores autism therapy rates after controversy | Optum leads $24M funding for startup aligning payers, providers

September 9, 2019

• UnitedHealth to insurers: Move specialty drugs out of hospital, save $4B | CMS issues Medicare fraud rule | Tenn. hospital employees lose Florida Blue insurance | Cigna, claims processor settle chiropractor lawsuits for $20M

September 5, 2019

• Miami hospital to repay $412M in Medicaid payments | Patient dies after visit from suspicious man at Phoenix hospital | CVS-Aetna deal official | Humana expands primary care network

September 4, 2019

• United-TeamHealth spat may have industrywide effects: Moody's | 'CMS pulled the rug out from under us,' Idaho lawmakers say after waiver rejected | Providence Health Plan warns 122,000 members of data breach | 24 healthcare leaders named 'most innovative'

September 3, 2019

• Horizon BCBS sues physician advocacy group over 'smear campaign' | CMS wants to change rules for maintaining Medicare billing privileges | BCBS Association's CMO resigns months after CEO announces retirement | 2 Mich. health plans to merge

August 29, 2019

• 5 physician execs on transitioning to payer roles | This Medicare Advantage insurer is nearing $1B in revenue — CEO John Kao explains how | 18 payer exec moves | BCBS of Illinois invests in housing

August 28, 2019

• 2 Fla. hospitals fight for Medicaid funding | Ex-Molina CEO named dean of med school | UNC Hospitals placed on probation by Joint Commission | Blue Shield of Calif. CTO Dr. Karen Xie on her technology philosophy

August 27, 2019

• Tenn. prepares Medicaid block grant plan | Ohio hospital's Medicare contract jeopardized | Americans trust payers, hospitals less than physician offices with their data: poll | 26 hospital exec moves

August 26, 2019

• Aetna changes Kan. leadership with Medicaid contract in jeopardy | Kaiser to court: Stop Hawaii health system from balance-billing our members | DOJ seeks dismissal of UnitedHealth suit | 5 payers expanding their 2020 products

August 22, 2019

• 'Medicare for All' would force Colo. hospital to close, CFO says | AHIP CEO rejects Biden's healthcare plan | Why a Ky. hospital lost its Medicare funding | Aetna, Centene protest losing bids to manage Medicaid in La.

August 21, 2019

• Providence to partner with largest Ore. Medicaid plan | Cigna exploring sale of $6B group insurance unit | UHS execs, directors escape billing lawsuit | Health insurance becoming unaffordable for employees, too

August 20, 2019

• Anthem, Cigna CEOs among 181 leaders pivoting toward society, not just profits | Lawsuit involving BCBS of La. subsidiary heads to SCOTUS | Trump donates salary to HHS for 3rd time | ACA 'still needs wholesale reform': WSJ editors

August 19, 2019

• Highmark CEO says UPMC deal to lure members, but patient retention mixed | Healthcare stocks may be losing resiliency, Bloomberg op-ed argues | AMA leaves anti-single payer group | Star ratings coming to ACA plans

August 15, 2019

• 10 payer exec moves | Tenn. hospital loses Medicare billing privileges | How 10 top health insurers ranked on website satisfaction | Medicare Advantage growth among biggest for-profit payers

August 14, 2019

• Tufts Health, Harvard Pilgrim to merge — again | Aetna's Medicaid correction plan falls short in Kan. | Insurers must cover kids' EpiPens in Ill. | Improve Medicare audits, physicians urge

August 13, 2019

• Ky. health system targets million-dollar 'shock claims' in Anthem deal | Humana sues Mallinckrodt over '97,500%' increase in gel price | Couple's murder-suicide prompted by medical bill worries: sheriff | Forbes: Could HCSC exec exits signal Anthem deal?

August 12, 2019

• Centene is 'callous,' Senate leader says after meeting with insurer's CEO | GOP ready to revive ACA repeal talks | UnitedHealth: Hospital inpatient prices up 19% over 5 years | Medicare to save $650M under pay proposal

August 8, 2019

• Texas health system beats $61.8M false claims case | Highmark Health posts $629M net income | Trump healthcare overhaul coming in Sept. | Optum, John Muir Health talk partnership | How payers can benefit from blockchain

August 7, 2019

• Aetna risks losing Kan. Medicaid contract | Cigna plans major Medicare Advantage expansion | Ill. hospital files for bankruptcy | Insurer drops CVS for Express Scripts | 3 things to know about Anthem's enrollment

August 6, 2019

• WellStar: Anthem deceived customers | 6 exec resignations | UnitedHealth offers free emotional support line after mass shootings | 1 more system joins NC's controversial reimbursement plan | Humana picks up La. Medicaid contract

August 5, 2019

• 20 payer exec moves | HCA defeats false claims lawsuit | CMS' final inpatient payment rule for 2020: 8 takeaways | 10 best, worst states for healthcare | WSJ: Trump administration working on alternative to 'Medicare for All'

August 2, 2019

• Humana beefs up bonuses for 50,000 employees | BCBS of Mich. hit with $40M lawsuit over provider payments | Vt. orders 5 unlicensed parties to stop selling health insurance | Cigna's Q2 profits grow to $1.4B

August 1, 2019

• Big payers, tech, hospitals partner on medical claims standards | Trump to unveil healthcare measure every 2-3 weeks | Humana's individual MA growth highest in decade; profit soars 387% | Public option polls ahead of 'Medicare for All'

July 31, 2019

• Big payers, tech, hospitals partner on medical claims standards | Trump to unveil healthcare measure every 2-3 weeks | Humana's individual MA growth highest in decade; profit soars 387% | Public option polls ahead of 'Medicare for All'

July 30, 2019

• CMS' proposed payment rules: 10 things to know | Ariz. hospital apologizes for $60K billing error | 21 hospitals named to US News' Honor Roll | Humana sues St. Jude Medical over pacemaker costs

July 29, 2019

• HCSC CFO resigns days after CEO | UAB Health CEO on UnitedHealthcare: Make $9B, but not on the backs of patients | 2nd Ben Taub patient found dead in bathroom | Minn. hospitals: BCBS' incompetence, not prior authorization, is the problem

July 25, 2019

• HCSC CEO is out | CMS: Ben Taub patient found dead in bathroom | Health plan trained physicians to overbill Medicare: lawsuit | Minn. insurer to expand offerings 300%

July 24, 2019

• Centene CEO: WellCare deal may close early | Anthem's profit climbs to $1.1B amid IngenioRx rollout | Pa. hospital closure may increase employees' out-of-pocket costs | 5 'Medicare for All' updates

July 23, 2019

• 'Medicare for All' unlikely to increase hospital use: study | Feds: Physicians, pain clinic chain CEO ran $25M billing scheme | UnitedHealth: Unneeded ER visits cost $32B a year | The 2020 Democratic candidates for private insurance under reform

July 22, 2019

• Trump's short-term health plans upheld | BCBS of Minn. defends policies that hospitals call unlawful | Anthem's new app allows nonmembers to schedule, pay for care | Cook County Health CEO: Impending Medicaid DSH cuts are 'immoral'

July 18, 2019

• UnitedHealth records $3.3B profit | BCBS of Mass. global payments may slow spending | MSSP sees decline in new ACOs | Surprise billing legislation moves forward with arbitration amendment

July 17, 2019

• NY insurer opens office in hospital | Optum to help Calif. health system remain independent | Humana shares hit highest mark since Feb. | Intermountain launches value-based care company

July 16, 2019

• Probe BCBS, Minn. hospitals urge state | Billions in MA overpayments in CMS' crosshairs | Mich. surgeon accused of $60M billing fraud | Hospitals hire 'secret shoppers' to evaluate quality

July 15, 2019

• Biden's health plan arrives: 8 things to know | Quality Payment Program results: 5 things to know | Generic drugs 'wildly overpriced' in Medicare, researchers say | Mass. residents bought fake health insurance: state

July 11, 2019

• Trump's kidney care executive order + CMS' new payment model: 12 things to know | 'Burn in hell,' Cone Health manager tells health plan | Clover Health launches drug company | Cigna scoops up ex-Aetna physician for medical exec role

July 10, 2019

• Anthem poaches Apple employees | ACA hearing: 6 things to know | Google more accurate than MA directories | UnitedHealth: Cancer case judge recused himself from is flawed

July 9, 2019

• Aetna, 7-hospital network launch ACO | Fla. hospital keeps Medicare contract after sex abuse scandal | Seattle Children's cited after mold leaves 1 patient dead | Private sector workers increasingly enrolling kids in Medicaid, CHIP

July 8, 2019

• UnitedHealth feud pushes 17,500 Fla. hospital patients out of network | Oral arguments in ACA challenge start July 9 | 5 quotes from Express Scripts tech chief on $67B Cigna deal | Ex-Optum VP to lead urinalysis startup

July 3, 2019

• BCBS of Ariz. CMO on greatest challenge facing payer execs | UPMC Children's confirms 12 MRSA cases | 22 hospital + 16 payer exec moves | 5 states ask to join CVS-Aetna hearing

July 2, 2019

• 17 execs on the future of the payer-provider relationship | SF hospital CEO resigns amid patient abuse scandal | Piedmont launches pay-upfront policy | Medicare outpatient claims-processing changes delayed

July 1, 2019

• BCBS of Mich. launches Medicare venture | UnitedHealthcare CEO to retire: 5 notes | 5 things driving 2020 premium rates | UnitedHealth, Anthem, Humana shares up after Democratic debates

June 26, 2019

• UnitedHealth buys tech firm targeted by feds | Payer stocks hit by Trump exec order | Ariz. Medicaid now pays for Lyft rides | Tufts Health Plan to pay members to find cheaper providers

June 25, 2019

• BCBS of Minn. buys stake in hospital's 20 clinics | Trump's order on healthcare costs: 7 notes | Blame insurers for surprise bills, 81% of Americans say in poll | Ky. hospital sued after workers' health plan axed

June 24, 2019

• UPMC, Highmark strike 10-year contract | Supreme Court to hear $12B ACA insurance dispute | Hacienda HealthCare to lose Medicaid funding | UnitedHealth to buy payments firm for $3.2B

June 20, 2019

• Cigna CEO: Public-private partnerships more promising than 'Medicare for All' | UnitedHealth gets conditional FTC approval to buy DaVita physicians | Hospital readmission costs for 18 diagnoses | Insurers launch SDOH project

June 19, 2019

• Mount Carmel's Medicare contract still at risk | BCBS of Mass. CEO: 30M uninsured is 'morally, politically and economically unacceptable' | Centene, WellCare get key endorsement | 5 things to know about Humana Radio, streaming to 50,000 employees

June 18, 2019

• GOP voters understand 'Medicare for All' better than Dems, poll finds | UnitedHealth rejects claim review in mental health case | 10 best children's hospitals: US News | CMS wants to update Medicare Part D's e-prescribing standards

June 17, 2019

• Kaiser partially blames hospitals for Colo. exits | Trump: Healthcare plan coming in next couple months | Fallon Health's move to stop ex-CFO from joining Aetna denied | Beacon Health accused of denying payments amid Anthem takeover

June 13, 2019

• Fla. insurer hit with lawsuit over skimpy plans | Nat'l healthcare scorecard: Where does your state rank? | Kaiser sues Hawaii hospital system over balance-billing plan | Henry Ford Health insurer's CEO Terri Kline on Medicaid acquisition

June 12, 2019

• 'Medicare for All' shot down in AMA vote | Humana warns 5,500 members of data breach | CMS finds serious deficiencies at MD Anderson | CVS stock slides on report judge will squash Aetna deal

June 11, 2019

• Humana, Epic partner | Medical cost-sharing ministries see surge in revenue, members — and complaints | 10 updates on payer-provider relations | Henry Ford's insurer buys 9,000-member plan

June 10, 2019

• Anthem to buy behavioral health provider with 36M patients | State-by-state breakdown of largest commercial, MA payers | 5 updates from the CVS-Aetna hearings | 'Medicare for All' gaining support from small business CEOs

June 6, 2019

• Medicare termination forces Ky. hospital to halve workforce | Payers & providers, watch out: Patients want a spot at the negotiating table | UPMC backpedals on prepay policy | Q&A: Allina Health | Tom Lindquist, CEO of Allina-Aetna, on JV's first year

June 5, 2019

• BCBS Association CEO to retire | Optum won't build hospitals, UnitedHealth CEO says | 10 biggest health plans by covered lives | Hospitals can't challenge Medicare payment methodology, court rules

June 4, 2019

• UnitedHealth to Supreme Court: Back controversial billing method | Humana CMO on strategy, 'Medicare for All' and home care as healthcare's Netflix | 10 best, worst states for jobs | Rutgers, Horizon BCBS partner

June 3, 2019

• BCBS Association wants federal ban on balance billing | Humana dispels rumors of Centene takeover | Supreme Court sides with hospitals in multibillion-dollar payment dispute | CVS builds defense for Aetna deal

May 30, 2019

• Cigna CEO's threat to leave Conn. derailed public option, official says | Tenn. hospital to lose Medicare contract | Passport Health sells majority stake | 'Beyond horrifying': UNC continued surgeries as cardiologists warned of problems

May 29, 2019

• CMS terminates Ky. hospital's Medicare contract | Meet the 173 members of AHIP | Ill. system resorting to liens instead of billing insurance: lawsuit | 'Burnout' gets ICD-11 code

May 28, 2019

• UnitedHealth hasn't closed $4B DaVita deal | Trump is drafting order to force healthcare cost disclosures | Centene should consider selling itself, activist fund says | Deadline to apply for CMS navigator funding: July 22

May 23, 2019

• Insurer sites spend millions to top Google searches | CEO unexpectedly leaves Colo. payer | Mold forces OR closures at Seattle Children's | 25 most valuable healthcare brands — UnitedHealth No. 1

May 22, 2019

• Employer plan deductibles up 150% in 10 years | The drawbacks of net promoter scores | Cigna, 8-hospital Ohio system hit contract snare | Mike Pence's quiet takeover of HHS

May 21, 2019

• Physician: Fraudster stole identity to bilk Medicare | Walmart prefers these 16 health systems for employees | 10 things to know about Optum | Patients sue HCA over ER 'cover charge'

May 20, 2019

Walmart steers workers to 800 imaging centers to avoid misdiagnoses | Optum funnels millions into startup | 41 healthcare companies make Fortune 500 | JPMorgan Chase buys InstaMed for $500M+

May 16, 2019

Chicago hospital blames insurers for ICU cuts | CMS targets spread pricing in new guidance | The 50 hospitals that got F's and A's from Leapfrog | CEOs rank 10 best, worst states for business

May 15, 2019

Fla. hospital recoups contested Medicaid payments | 5 latest billing fraud settlements | Leapfrog spring safety grades out | Trump's short-term health plans unfit for cancer patients, group says

May 14, 2019

Anthem must testify on WellStar dispute | 5 best, worst states for healthcare | Physicians quit Maine hospital as morale hits 'all-time low' | Miss. hospitals propose $20-a-month insurance plan

May 13, 2019

Mass General president: Size helps Partners set high prices for insurers | 15 health plans members like most | Zuckerberg hospital to lose revenue after billing revamp | 27 exec moves

May 9, 2019

UnitedHealth launches maternity bundles | CHS will go bankrupt, hedge fund manager says | Private insurers pay hospitals 2.4 times more than Medicare | Ex-Humana employee pleads guilty to defrauding insurer

May 8, 2019

UnitedHealth CEO buys record 20,000 shares | DOJ sides with Oscar in Florida Blue fight | WVU Medicine to acquire health plan | Payers mull coverage for Pfizer's $225K heart drug

May 7, 2019

Cigna's privacy officer steps down | 7 payer lawsuits | Tennessee pursues Medicaid block grant | Most-Googled disease by state

May 6, 2019

Aetna won't pay $150M in HCA hospital case | Texas, Maine hospitals at risk of losing Medicare funding | Hospitals to DOJ: Investigate Centene-WellCare | UPMC hits back at Pa. AG

May 2, 2019

Judge recuses self from UnitedHealth suit | DOJ moves to strike down ACA | Cigna profit up 50% after Express Scripts deal | Humana opposes 'Medicare for All'

May 1, 2019

Aetna sued over readmission payment policy | 10 cities with highest monthly insurance bills | Hospital charges $68K for 4 vials of snakebite antivenin | Ex-CEO of Fla. hospital chain settles false billing case

April 30, 2019

• UnitedHealth directors face investor lawsuit | Walmart has no shelf space for hospitals' shoddy healthcare | 10 best, worst states for nurses | 14 NC CEOs: It's time to expand Medicaid

April 29, 2019

• Aetna settles suit questioning ex-medical director's claim denials | 5 common questions about HIPAA | Trump administration mulls mandatory payment models | Prior authorization rules delay lifesaving cancer treatments, survey says

April 25, 2019

• Independence Blue Cross quadruples net income | Judge tosses UPMC's suit against Pa. AG | NC man struggling with addiction dies after using $33K BCBS check to buy drugs | 5 highest-paying jobs in medicine

April 24, 2019

• Contract impasse pushes 14 Texas ERs out of BCBS network while their hospitals remain in network | CMS' proposed IPPS rule for 2020: 9 takeaways | Humana, Doctor On Demand launch health plan | Anthem posts $1.6B profit

April 23, 2019

• UnitedHealth CEO made $21.5M last year | CMS unveils 5 primary care payment models | 29 exec moves | BCBS of La. accuses J&J unit of filing sham lawsuits to thwart competition

April 22, 2019

• Medicare hospital fund to run out in 7 years | UnitedHealth, Anthem top runners in Magellan deal | 100 great hospitals | 'Medicare for All' would drain hospitals of billions

April 18, 2019

• Mo. hospital fights for Medicare funding | Zuckerberg hospital revamps billing after controversy | CMS pitches $195M pay boost for inpatient rehab sites | Patient vents on billing: 'Was I supposed to wake up and say, 'No, stay in network'?'

April 17, 2019

• UnitedHealth CEO: 'Medicare for All' would destabilize health system | Humana debuts oncology payment model | Death of La. nurse attacked by patient ruled a homicide | Healthcare stocks take $28B hit

April 16, 2019

• CEO of Texas payer abruptly resigns | UnitedHealth's Q1 profit: $3.5B | Vt. pharmacy accuses insurer of steering members to mail order | Hackers tried to reroute payments of 5,600 Blue Cross of Idaho members

April 15, 2019

• Nev. hospital doesn't contract with payers | Sutter to resolve upcoding allegations for $30M | UPMC, Pa. AG head to state's highest court over Highmark spat | HHS hit with suit over suspended Medicare payments

April 11, 2019

• Centene, WellCare deal raises antitrust questions | Boston Children's sues Saudi prince over $3.5M bill | 7 found guilty in $40M Texas hospital kickback case | Trump officials appeal Medicaid work requirement ruling

April 10, 2019

• The top insurers all have PBMs: Here's who they are | Feds charge 24 in $1.2B telemedicine fraud scheme | 17 healthcare CEOs make list of overpaid execs | UnitedHealth expands bundled payment program

April 9, 2019

• Ohio insurer drops CVS Caremark | OptumRx: 5 costly drugs to watch | Hear 215+ execs speak at Becker's Health IT + Revenue Cycle conference | McConnell to AHA: 'Medicare for All' is bad for your hospitals

April 8, 2019

• BCBS to open clinics | Healthcare exec convicted in $1.3B fraud case | Pa. woman denied coverage for sepsis-related foot amputation | Judge to hear critics of CVS-Aetna settlement

April 4, 2019

• By the numbers: BPCI Advanced participants by condition | Walmart increasingly comparing physicians' cost | Hospitals largest employers in 16 states | Trump's short-term health plans resurface denial woes

April 3, 2019

• Duke Health, BCBS of NC launch insurer | Cigna-Express Scripts cap out-of-pocket insulin costs | Optum-owned pharmacy to close Houston sites | Average prices higher for outpatient healthcare, study finds

April 2, 2019

• UnitedHealth: Quality payments not to blame for Iowa Medicaid split | CMS finalizes Medicare Advantage, Part D rules | Lawsuit alleges Calif. hospital secretly recorded 1,800 patients | 10 most stressed states

April 1, 2019

• UnitedHealth abruptly exits Iowa's Medicaid program | 8 states with most, least surprise out-of-network bills | Webinar: Identify the weak points in your regional communication system | Ill. sues to reverse $145M in Medicaid repayments

March 28, 2019

• Medicaid work requirements struck down | CVS, Humana could lose out in Centene-WellCare deal | Insurer Clover Health to cut 140 tech jobs | 6 updates on payer-provider relations

March 27, 2019

• Centene to buy WellCare | Detroit hospital's Medicare funding in jeopardy | UnitedHealth invests $400M+ in housing | Medical billing could be ripe opportunity for Apple

March 26, 2019

• Health insurer with largest employer market share in each state | DOJ supports striking entire ACA | Join 215+ execs at Becker's Health IT + Revenue Cycle conference | 5 payer execs on industry's biggest challenges

March 25, 2019

• UPMC: Pa. AG working in Highmark's interest, not public's | 117 hospitals drop out of BPCI Advanced | 3 largest payers held 80% of market in 2015-16 | UnitedHealth rebates employers $146M

March 21, 2019

• Humana to expand primary care network | Vanderbilt hit with $25.5M suit over wrong-site surgery | Aetna to close another prescription delivery hub | How states are using Medicare rates to rein in hospital payments

March 20, 2019

• FTC: Fake health insurer still charging members millions | IBM director details Aetna blockchain ecosystem | 10 Medicaid updates | Optum sued over $16M in alleged drug overcharges

March 19, 2019

• Aetna to close Fla. drug office | BCBS of Minn. tech chief: AI 'bedrock' of personalized care | Join 170+ execs at Becker's Health IT+ Clinical Leadership + Pharmacy conference | CMS to adjust Medicare Advantage fines

March 18, 2019

• Amazon now accepting health savings accounts for medical purchases | 10 most common sentinel events | Walmart sees benefit of flying employees to top hospitals for care | Judge orders hearing on CVS-Aetna deal

March 14, 2019

• BCBS: Too late for UPMC to join federal antitrust lawsuit | Geisinger, Highmark to build Pennsylvania hospital | Democrats probe insurers' short-term health plans | Humana settles pregnancy discrimination suit

March 13, 2019

• Ex-Texas hospital CEO pleads guilty to defrauding 3 major insurers | 5 BCBS plans to combine | NY physician admits to plotting $16M billing scheme | Drones, self-driving cars part of Texas A&M Health, BCBS rural health plan

March 12, 2019

• UnitedHealth: Employers must pass drug rebates to workers | Trump's 2020 budget proposal: 5 healthcare takeaways | Join 170+ execs at Becker's Health IT+ Clinical Leadership + Pharmacy conference | 10 places with highest, lowest healthcare prices

March 11, 2019

• Health Care Service Corp. nets $4B in 2018 | CMS terminates Mo. hospital's Medicare contract | Humana CEO makes 231x average employee | Anthem: Physician acquisitions not in our strategy

March 7, 2019

• CMS puts multistate insurance on radar | Texas Health Aetna CEO: Integration key to payer-provider ventures | The 293 hospitals with 5 stars from CMS | Amazon, Berkshire, JPMorgan unveil name for healthcare firm

March 6, 2019

• UnitedHealth improperly denied mental health claims, judge rules | Anthem marketing made patients think WellStar, Emory in network: lawsuit | How CHS, Tenet, HCA and UHS fared in Q4 | Medicare Advantage membership for top 5 commercial plans

March 5, 2019

• Insurer off hook for Calif. hospital's $42M settlement | Tenn. hospital closes | Join 200+ speakers at Becker's Health IT + Clinical Leadership + Pharmacy conference | Chicago hospital's Medicare overpayments climb to $21M

March 4, 2019

• Best Buy, others to offer caregiver benefits | Anthem sued for sending massive checks to patients | CMS cuts payments to 800 hospitals | CVS-Aetna names CIO

February 28, 2019

• Payer stocks drop on 'Medicare for All' bill, drug hearings | Ind. hospital to close | 9 must-reads on medical billing | Humana CEO, execs unload $22.7M in stock

February 27, 2019

• UnitedHealth, Anthem, Permanente physicians: It's time hospitals, payers trust each other | Texas hospital allegedly paid physicians $40M in kickbacks | Medicare Advantage enrollment by state | Senate's drug price hearing: 6 takeaways

February 26, 2019

• Anthem: Cigna helped kill $49B merger | 31 exec moves | Texas hospital owner convicted in $20M fraud scheme | Medicare chief wants to overhaul primary care payments

February 25, 2019

• BCBS of Mich. accused of charging hidden fees | UPMC sues Pa. AG over Highmark dispute | Ex-Optum exec can join Amazon health venture | Insys tricked insurers into paying for fentanyl, ex-manager says

February 21, 2019

• Amazon, Berkshire, JPMorgan want to redesign insurance: testimony | 1 in 5 rural hospitals at high risk of closing | Health insurers' biggest pain point? Personalization, CIO of Wisconsin health plan says | US health spending to hit $6T in 8 years

February 20, 2019

• UnitedHealth's pharmacy unit owes Ohio bureau $16M, AG says | Top execs of 5 largest payers | Walmart drops virtual visit price from $40 to $4 | Health insurers steer employer benefit decisions with broker bonuses

February 19, 2019

• Medicare plans with poor Star Ratings face termination | UPMC Pinnacle to close hospital | 170+ speakers at Becker's Health IT + Clinical Leadership + Pharmacy conference | Insurers win legal fights over ACA payments

February 18, 2019

• Walmart strikes deal with Ochsner for joint replacements | Kan. hospital abruptly closes | La. physician, supervisor plead guilty to Medicare fraud | BCBS Association CEO to testify in Anthem-Cigna breakup

February 14, 2019

• Blue Shield underpaid Calif. hospital system for ER services, jury says | Ind. hospital overbilled Medicare $22M | Ohio hospital to close | Calif. payer mulls bankruptcy

February 13, 2019

• UnitedHealth adds ex-Mayo Clinic CEO Dr. John Noseworthy to board | 10 states with highest, lowest employer spending | Okla. hospital's Medicare funding at risk | Optum's trade secrets appeal to be fast-tracked

February 12, 2019

• Employer health plan spending hits all-time high | 10 arrested in $42M healthcare billing fraud scheme | Hear 81 CEOs + 45 CFOs at Becker's 8th annual roundtable | BCBS plans launch food delivery service

February 11, 2019

• UPMC to litigate over Highmark consent decree | OptumRx sets demands for drugmaker price reductions | Catholic Health invests $100M+ in move to Epic EHR | Humana CFO: Trump's drug plan will raise premiums

February 7, 2019

• Pa. to probe Highmark-UPMC split | Lyft expands partnership with Medicare plans | CMS bending Medicaid rules for work requirements | Walgreens pays nearly $2M to settle claims with MassHealth

February 6, 2019

• Anthem faces class-action lawsuit over WellStar dispute | Specialty pharmacy settles Medicare fraud lawsuit for $17M | Oscar names CFO | Judge pauses Optum's suit seeking to protect trade secrets

February 5, 2019

• Okla. hospital may lose Medicare funding | Hospital prices inflate cost for privately insured: study | Hear 140+ execs at Becker's Health IT + Clinical Leadership + Pharmacy Conference | State of the Union guests to highlight surprise medical bills

February 4, 2019

• Anthem stocks hit record high | Johns Hopkins All Children's, Mount Carmel could lose Medicare funding | Dignity Health, CHI merge into $29B system | Zuckerberg hospital puts balance billing on hold

January 31, 2019

• CMS proposes changes for private Medicare plans | UnitedHealth stops sharing claims data with HCCI | Tenn. hospital to close | New details on Amazon-Berkshire-JPMorgan health venture emerge

January 30, 2019

• $2.2M health insurance error traced to mistaken identity | Ex-CEO gets 46 months in prison for defrauding Fla. hospital | GoFundMe CEO: A third of site's fundraisers are medical-related | Anthem to end Express Scripts contract early

January 29, 2019

• UnitedHealth faces $91M fine after Calif. Supreme court decision | 2 Detroit hospitals at risk of losing Medicare contract | Hear 170+ execs at Becker's Health IT + Clinical Leadership + Pharmacy conference | Aetna, Apple team up on health app

January 28, 2019

• BCBS of Miss. to stop paying for care it deems nonemergent | Amazon now sells hospital rooms | N.Y. hospital suing insurance plan over millions in reimbursement | Aetna, Anthem, 3 others launch blockchain ecosystem

January 24, 2019

• Kentucky health plan may be insolvent by mid-2019, CEO says | Optum sues employee who left for Amazon-Berkshire-JPMorgan venture | Hear 300+ executive speakers at Becker's 10th Annual Meeting | Ascension restructures leadership; 3 execs depart

January 23, 2019

• Anthem, WellStar to let contract expire | Walgreens pays $269M to settle billing fraud lawsuits | Bankrupt hospital chain receives $610M | 38 hospitals sue HHS over site-neutral payment policy

January 22, 2019

• UnitedHealth sues generic drugmakers for price fixing | Ohio hospital loses Medicare certification | 50 states ranked by opioid overdose death rates | CMS updates 2 payment models

January 17, 2019

• 5 health systems to share risk under BCBS agreement | Apple should buy Epic, Jim Cramer says | Supreme Court hears arguments in Allina's Medicare reimbursement case | CVS-Aetna review must continue during shutdown, judge orders

January 16, 2019

• Apple talking with private Medicare plans to subsidize watch | Humana names UPMC exec CMO | Coding error leads to $5K charge for 4 stitches | Court affirms ruling in UnitedHealthcare billing case

January 15, 2019

• Optum revenues top $100B | Ex-Humana director launches hospital compare site | Hear 140+ clinical leaders at Becker's 2nd Annual Health IT + Clinical Leadership + Pharmacy Conference | Mont. hospital pays $10M kickback settlement

January 14, 2019

• Physician assistant admits role in $1B Medicare fraud scheme | America's largest health insurers | No. 1 takeaway from 2019 JP Morgan Healthcare Conference | Humana can't seal documents as nonparty in antitrust suit

January 10, 2019

• 10 best jobs in healthcare, ranked by US News | Medicaid gets new acting director | Aetna fined over substance misuse, autism coverage | The health insurance industry in 2019: 4 things to know

January 9, 2019

• NYC health plan aims to cover all uninsured residents | Billing feud between CHS and Quorum ends with arbitration ruling | CVS debuts programs month after acquiring Aetna | Payers expect 3% minimum drug price hikes for next 3 years

January 8, 2019

• Former Anthem CEO Joseph Swedish starts private equity firm | Zuckerberg blasted over billing at Calif. hospital with his name | Join 300+ hospital exec speakers at Becker's annual meeting | Health insurers upcharged Medicare $9B for drug plans

January 7, 2019

• Calif. medical group to shut down after Molina cancels contract | Zuckerberg hospital is out of network with all private insurers | Medicare underpaid hospitals by $53.9B | Humana, BCBS of Michigan face data breaches

January 3, 2019

• Student health insurer abruptly shuts down | Cleveland Clinic fires physician over anti-Semitic comments | Centene buys majority stake in Spanish hospital | Medicare bundled payment program cuts spending

January 2, 2019

• GE's long-term care insurance dilemma | 10 biggest private equity healthcare deals of 2018 | UnitedHealth's Optum signs telehealth deal with VA | Minn. hospital apologizes for billing mistake

December 31, 2018

• Tenet on Cigna dispute: Being forced out of network is 'unsure-ance' | Ky. hospital blames Medicare error for delay in paying workers | The healthiest, unhealthiest states in America | BCBS of Michigan data breach potentially affects 15,000

December 27, 2018

• Amazon to take on health insurance, analyst says | UnitedHealthcare, Duke LifePoint talks reach critical point | Medscape: Best, worst physicians | Pa. lawmakers seek CMS' advice on UPMC-Highmark split

December 26, 2018

• Walgreens execs: Humana JV could be primary care template for stores | W.V. hospital, CEO hit with federal kickback suit | 950 ProMedica physicians, Aetna end dispute | 9 healthcare lawsuits

December 24, 2018

• Kaiser settles allegations it urged mental health patients to drop insurance | 5 healthiest, unhealthiest states | CMS overhauls ACO program | Texas psych hospital to lose Medicare funding

December 20, 2018

• Cigna-Express Scripts deal closes | SC hospital shutters | Pharmacy owner sentenced in $8.4M billing scheme | Cleveland Clinic Florida + 3 hospitals join Humana's value-based network

December 19, 2018

• BCBS allegedly defrauded $10M by NJ man | Fla. hospital CEO can sue CNN for defamation, judge rules | Oscar: 91% of members' issues resolved via app | Medicare contractors overpaid hospitals for radiation services, OIG finds

December 18, 2018

• UnitedHealth to buy DaVita Medical Group for $560M less | Aetna's chief digital officer: 'Insurance will change dramatically' | Hear 140+ physician speakers at Becker's 17th Annual Future of Spine event | Average cost per inpatient admission: $22K

December 17, 2018

• Molina Healthcare battles with founding family | Federal judge strikes down ACA | 4 hospitals miss payroll in Okla., Tenn. | BCBS must face antitrust lawsuit, judge says

December 13, 2018

• Tenet, Cigna dispute ramps up | Aurora Health will pay $12M to resolve improper compensation claims | 3 top Johns Hopkins All Children's execs resign | Fitch: Insurers' 2019 outlook stable

December 12, 2018

• Feds join Medicare Advantage fraud case against Sutter Health | UnitedHealth's Optum hires Mayo Clinic Arizona CEO | Glassdoor: 9 best hospitals to work for in 2019 | 2 physicians charged in $4.7M billing scheme

December 11, 2018

• UnitedHealthcare, Envision extend contact | AHIP, BCBS unite to fight surprise billing | Becker's seeks speakers on blockchain, AI | High premiums major worry for 61% of Americans

December 10, 2018

• ProMedica physicians: Aetna hasn't increased rates in 6 years | MedPAC mulls direct Medicare billing for NPs, PAs | Amazon on healthcare hiring spree | CMS finalizes risk adjustment rule

December 6, 2018

• Mass. hospital to settle Medicare overpayments | Texas health system abruptly shuts down | BCBS beats lawsuit alleging ER underpayments | Half of MA directories have errors

December 5, 2018

• Aetna spins off Part D business | Hospitals sue HHS over site-neutral payment policy | Leapfrog's 2018 top hospitals | Texas hospital bills wrong patient $13K

December 4, 2018

• BCBS Texas exec: 'Stand with your carrier' amid hospital disputes | Tenet sells health plan | Join 300+ exec speakers at Becker's Annual Meeting | Aetna, Ascension join blockchain pilot project

December 3, 2018

• WSJ: Employers look for new ways to cut health insurance costs | Phoenix Children's, BCBS extend deadline for new contract | CVS stores will look more like clinics after Aetna deal | Humana rebuys $750M of common stock

November 29, 2018

• CVS closes $70B Aetna deal | 10 states with least competitive commercial insurance markets | Amazon to sell EHR-mining software | NewYork-Presbyterian CEO Dr. Steve Corwin faces pushback on 'Medicare for All' stance

November 28, 2018

• UnitedHealth to buy primary care clinic | Detroit hospital cited after insects found in ICU | N.C. to feds: Recover millions in hospital overpayments | AHIP Facebook ad targets negative view of insurers

November 27, 2018

• CMS proposes changes to Medicare drug rules | UnitedHealth: Revenues to surpass $240B in 2019 | Hear Katie Couric, Bill Clinton, George W. Bush at Becker's 10th Annual Meeting | Calif. approves CHI-Dignity merger, with conditions

November 26, 2018

• Mich. hospital recommends woman fundraise for denied heart transplant | CVS-Aetna deal to close Nov. 28 | Idaho hospital offers 'Black Friday' deals | Analysts give Walgreens-Humana thumbs up

November 21, 2018

• Humana, Walgreens look to strengthen partnership | 4 dead in Chicago hospital shooting | 15 payer-provider contract disputes, resolutions | Thank-you notes from 14 health system CEOs

November 20, 2018

• Atrium settles antitrust lawsuit over payer contracts | Former BCBS exec heads to Amazon-JPMorgan-Berkshire venture | 25 exec moves | Oscar files preliminary injunction to halt Florida Blue's 'exclusive' broker policy

November 19, 2018

• NewYork-Presbyterian: Empire BCBS demanding $200M payment cut | CMS appeals Medicare Advantage overpayment ruling | CHI, Dignity name combined system | Partners, Harvard Pilgrim end merger talks

November 15, 2018

• 10 states with the lowest Medicare Advantage costs | Okla. hospital closes | UnitedHealthcare offers members a free Apple Watch | 5 questions with the CEO of 2017's best-performing MSSP ACO

November 14, 2018

• Tenet, Cigna hit contract snag | UnitedHealth exec's husband to settle insider trading allegations | CHS to divest S.C. health system | Humana's value-based contracts shrunk medical costs 16%

November 13, 2018

• Oscar sues Florida Blue over 'monopolistic' broker policy | Humana's CMO, HR chief sell millions in shares | 21 latest executive moves | Why Walmart, Home Depot are adopting this insurer tactic

November 12, 2018

• HHS' new mandatory bundled payment models: 4 things to know | Where are the 17 Leapfrog 'F' hospitals? | Humana CEO: Insurer will build on Walmart, Walgreens partnerships | CMS proposes changes to managed Medicaid, CHIP

November 8, 2018

• Humana stock hits all-time high | BCBS of S.C. to lay off 244 workers | Midterm elections: 5 takeaways for healthcare leaders | HHS to let some employers ditch ACA birth control mandate

November 7, 2018

• Aetna deal to bring more health services to CVS | Fla. hospital operator files for bankruptcy | Humana's net income climbs to $644M | Oscar Health to hire 400 in Ariz.

November 6, 2018

• Fla. firm made $100M selling fake insurance, FTC says | 9 specialties see pay hikes | Hear Terry Bradshaw at Becker's Health IT + Clinical Leadership conference | Cigna seeks $954K from Texas hospital after questionable billing uncovered

November 5, 2018

• CMS' final outpatient payment rule for 2019: 7 things to know | PeaceHealth accused of overbilling Medicare patients | UPMC faces class-action lawsuit | Envision maps out UnitedHealthcare dispute in new site

November 1, 2018

• CMS to recoup $1B in improper Medicare payments by 2020 | UnitedHealth's OptumRx can't escape EpiPen price lawsuit | CHS' shrinking hospital portfolio: 9 latest divestitures | Cigna posts $772M profit

October 31, 2018

• Aetna owes HCA hospitals $150M, arbitrator says | Anthem's profit jumps 29% | Ochsner Health, Walmart to launch health plan | Feds: Kan. physician partook in $30M billing fraud scheme

October 30, 2018

• Alaska hospital may lose Medicare funding | Ex-UnitedHealthcare CMO hired by Ohio health system | UPMC physician among 11 killed in Pittsburgh synagogue shooting | BCBS of Massachusetts to pay hospitals to keep patients out

October 29, 2018

• Iowa hospital sues Medicaid insurers | CHI allegedly defrauded of millions by IT employee, 2 others | CMS told to 'hit pause button' on Medicaid work requirements | 24 cities with higher-than-average healthcare prices

October 25, 2018

• Anthem snags former Google leader to manage AI | Aetna's $50M overbilling suit against medical group moves forward | 7th death reported in NJ adenovirus outbreak | Medicaid enrollment falls for 1st time in decade

October 24, 2018

• Microsoft to debut employee health plan | BCBS, NJ community hospital settle network lawsuit | HCA to close Miami hospital | Medical equipment firm to settle false billing claims for $5M

October 23, 2018

• Trump administration's new insurance guidelines for states, employers | 8 latest private equity healthcare deals | 300+ hospital executives to speak at Becker's Hospital Review 10th Annual Meeting | Moody's top risks for payers, providers

October 22, 2018

• UnitedHealth paying $69B toward value-based agreements | Hospital execs see jump in compensation | Oscar wants to use telemedicine for complex conditions | Do private Medicaid plans boost quality, cost savings? Evidence is shaky, report says

October 18, 2018

• Health plans defrauded in $1B telemedicine scheme: DOJ | Miss. system blames Humana split on denials | Former HHS, athenahealth leaders raise $360M to sell MA plans | CEO of Steward hospital replaced weeks after CFO departs

October 16, 2018

• UnitedHealth posts $57B revenue; Optum picks up pharmacy | Anthem to pay record $16M HIPAA settlement | Terry Bradshaw, Bobbi Brown to keynote Becker's 2nd Annual Health IT + Clinical Leadership conference | Amazon to expand health plan team

October 11, 2018

• The 2019 Medicare plans with 5 stars | CMS to terminate Texas hospital's Medicare contract | Kaiser pins $65M loss in Colo. on 'unfair business practices' | 1,299 providers to join BPCI Advanced

October 9, 2018

• Walmart, GM should be 'wake-up call' for insurers | Struggling Okla. hospital solicits donation from country music star | Hear Katie Couric at Becker's 10th Annual Hospital Review Meeting | Trump's short-term health plans are here

October 4, 2018

• Walmart is changing how we pay for healthcare | $20K: The average yearly premium for families | EEOC sues Saint Thomas Health over mandatory flu shot policy | UPMC, Highmark face off over out-of-network prepayment rule

October 2, 2018

• HCA, BCBS of Ga. break ties | Calif. hospital operator enters bankruptcy after Anthem sues | Join Lloyd Dean and Michael Dowling at Becker's 10th Annual Meeting | Meet Cigna-Express Scripts' executive team

September 27, 2018

• Aetna to sell Medicare Part D business | CMS miscalculated MIPS payments | CHS subsidiary to pay $262M to settle fraud probe | NYC Health + Hospitals seeks $40.1M from UnitedHealthcare

September 25, 2018

• UnitedHealth warns hospitals about Envision contracts | 19 hospital, health system exec moves | Hear 80 CEOs and 50 CFOs speak at Becker's 7th Annual CEO + CFO Roundtable | 47 top-rated commercial health plans

September 20, 2018

• How hospitals' contracts with insurers block cost-cutting efforts | 8 payer lawsuits | Cyberattack forces Ind. hospital to cancel surgeries, divert ambulances | Can patients with HSAs deduct new Apple Watch as medical device? Not yet

September 18, 2018

• What $52B Cigna-Express Scripts deal means for healthcare | Zuckerberg to tackle disease with $13B Facebook stock sale | Join keynotes Hillary Clinton, Theo Epstein at Becker's 7th Annual CEO + CFO Roundtable | Partners settles deceptive billing case

September 13, 2018

• Netflix co-founder to healthcare execs: Grow 'tolerance of risk' | UnitedHealthcare, Humana CEOs unload millions in stock | Pharma CEO: 400% price hike for generic drug 'moral requirement' | N.Y. hospital says patient kept its $1.5M insurance payment

September 11, 2018

• Azar: Advancing value-based agenda 'is going to mean mandatory models' | Ill. hospital closes | Hear 80 hospital CEO speakers at Becker's 7th Annual CEO + CFO Roundtable | SD hospital's Medicare funding still at risk

September 6, 2018

• Premera Blue Cross accused of destroying evidence in data breach case | CVS-Aetna, Cigna-Express Scripts deals set for approval | Apple is hiring for its health business | CMS erroneously sends termination letters to 38K+ BCBS Medicare members

September 4, 2018

• Comcast is reinventing employee healthcare | 10 best, worst states for health insurance coverage | Top 25 hospitals to work for in 2018, ranked by Indeed | Medicare is driving ACO growth

August 30, 2018

• Erlanger: Tenn. Medicaid puts insurers before safety-net hospitals | Highmark to pay ambulance companies for care outside hospital | Vanderbilt points to Epic rollout for 68% drop in operating income | Calif. physician jailed for billing fraud

August 28, 2018

• Blue Cross: N.C. hospital engaged in a '$76M health insurance swindle' | Miss. hospital files for bankruptcy | Join 3,500+ attendees at Becker's Health IT + Revenue Cycle conference | UnitedHealth stock hits all-time high

August 23, 2018

• Anthem not complying with Medicare payment investigation, feds say | S.C. hospital to close | Blue Shield of Calif. erroneously cancels coverage | Physician sentenced for role in $30M billing scheme

August 21, 2018

• Aetna accuses hospital management firm of billing fraud | Mich. hospital blames 'aggressive, direct competitor' for financial troubles | 25 CFO speakers added to Becker's 7th Annual CEO + CFO Roundtable | Amazon in talks to create UK insurance tool

August 16, 2018

• UnitedHealthcare's CMO out weeks after taking role | Providence Health accused of $188M upcoding scheme | HCA stock hits record high | Why health insurers may soon pay your rent

August 14, 2018

• Humana divests $2.4B long-term insurance unit | Proposed payment changes to ding hospital margins | Join 78+ CEOs at Becker's 7th Annual CEO + CFO Roundtable | Sharp, Providence Health, MemorialCare collaborate with Aetna

August 9, 2018

• UnitedHealth picks up physicians in recent deal | Ga. hospital visitor injected pink liquid into patient's IV, police say | Join 4K attendees at Becker's Health IT + Rev Cycle conference | Cigna wins Texas hospital's suit over $50M in unpaid claims

August 7, 2018

• Humana sues drugmakers | CMS releases 2019 final inpatient payment rule | 10 best, worst states for healthcare | Carl Icahn publicly opposes $54B Cigna-Express Scripts deal

August 2, 2018

• Aetna, Cigna, Humana report strong Q2 results | Miss. hospital's ER charge covered in full by 1 insurer, another paid 13% | CHS divests 425-bed Florida hospital | Activist investor to vote against $54B Cigna-Express Scripts deal

July 31, 2018

• Ascension, Centene to explore Medicare Advantage joint venture | Tenet hospital's Medicare contract at risk — again | 16 top CFOs added to Becker's CEO + CFO Roundtable | Kaiser ends Medicaid coverage for 2.5K patients in Colo.

July 26, 2018

• Anthem posts $1.1B profit | CMS' proposed outpatient payment rule: 10 things to know | Texas health system files for bankruptcy | Charge to 'use a sink' at Las Vegas ER outrages patient's parents

July 24, 2018

• UnitedHealth may drop 1.2K Northwestern physicians | 491-bed Ohio hospital closes | Anthem, American Well, Samsung team up | What is the healthcare industry's greatest challenge? Becker's wants your take

July 19, 2018

• UnitedHealth explores acquisition of Tenet's Conifer business | Anthem denied 12K claims under ER policy, but paid most | Tenet to exit Chicago | Why health insurers care when you binge-watch Netflix

July 17, 2018

• Anthem sued by Ga. physicians over ER policy | CMS releases proposed physician payment rule | Hear keynotes Peyton Manning, Venus Williams at Becker's 4th Annual Health IT + Revenue Cycle Conference | Health insurers overtake hospital stocks

July 12, 2018

• Humana pays back wages for violating overtime rules | Shuttered Calif. hospital sues insurer | Chicago hospital needs $3M infusion to avoid closure | 300+ Aetna members overdose on opioids each month — Here's what Aetna is doing about it

July 10, 2018

• UnitedHealth, dialysis provider settle fraud lawsuits for $32M | Ex-telemarketing CEO gets 5-year sentence for health insurance fraud | Join CEOs David Feinberg, Chris Van Gorder at Becker's CEO + CFO Roundtable | CMS to allow hospitals to withdraw from BPCI Advanced in March

July 5, 2018

• Humana suffers 'spoofing' cyberattack | CMS extends BPCI Advanced deadlines | 1 in 3 GoFundMe campaigns are for medical bills | Ex-employee sues Memorial Hermann for $1M

July 3, 2018

• Idaho hospital to lose Medicare billing privileges | Miss. man refuses CT scan until confirming insurance coverage — then gets hit with $3,878 bill | Mich. hospital sues 3 patient relatives over Facebook post | Pharmacy operator, employees charged in $200M health insurance fraud scheme

June 28, 2018

• Ind. hospital: Anthem won't ink fair rates because it considers us a microhospital | Amazon to buy online pharmacy PillPack | Parents charged $15,666 trauma fee after baby takes nap, drinks formula in ER | Partners to insure all employees, taking them off BCBS

June 26, 2018

• Houston hospital's Medicare funding in jeopardy | Optum's Advisory Board acquisition 7 months later: 5 insights | Join 78 CEOs, 22 CFOs from hospitals and health systems at Becker's 7th Annual CEO + CFO Roundtable | Mississippi's only academic medical center to go out of network with BCBS

June 21, 2018

• Former CEO of Sentara-owned insurer to hospitals: 'Don't think you can duplicate' Kaiser | Oscar Health expands to 14 markets for 2019 | Dr. Atul Gawande tapped to lead Amazon, Berkshire, JPMorgan venture | 10 Medicare Advantage, 17 commercial plans ranked by members

June 19, 2018

• AHIP's next chair: Cigna CEO David Cordani | BCBS lets Mayo in on decision-making | Register for Becker's 4th Annual Health IT + Revenue Cycle Conference | Fla. health system accused of illegally poaching physicians from competitor

June 14, 2018

• UnitedHealth wins dismissal in Medicare Advantage fraud lawsuit | Opinion: Don't rule out an Anthem-Humana merger | Mayo Clinic attempts to block IRS from questioning CEO | Judge: BCBS plans can appeal lawsuit claiming automatic antitrust violation

June 12, 2018

• Blue Cross accuses NC hospital of overbilling by $76M | UnitedHealth to acquire 63k-member insurer | Kan. hospital loses Medicare billing privileges | Boeing, Cisco, Intel and Walmart are bypassing insurers to drive down healthcare costs

June 7, 2018

• Wis. hospital Medicare contract in jeopardy | Optum part of $2.2B deal to acquire physician firm | Second body found at San Francisco hospital in 1 week | Anthem sues Calif. hospital over alleged toxicology lab fraud

June 5, 2018

• Anthem's new imaging rule likely to hit hospitals' profits | RN wages by state | Hear Peyton Manning, Venus Williams at Becker's 4th Annual Health IT + Revenue Cycle Conference | BCBS of Texas delays contested ER policy

May 31, 2018

• Aetna, newborn physician firms embroiled in lawsuits over payments | Why airlines hope physicians aren't on board during medical emergencies | Humana sues government to keep details of $45B Tricare deal under lock | Former Optum exec fills CEO role at 3-hospital system

May 29, 2018

• NYC Health + Hospitals: UnitedHealthcare owes $11.5M in wrongful denials | Texas man receives $7,924 surprise bill after going to in-network ER | Nurse awarded $28M in retaliation suit against Brigham and Women's Hospital | 5 things to know about Kaiser's health plan

May 24, 2018

• Ex-Anthem fraud investigator charged in $20M billing scheme | Mayo sells health plan set to close | Tenet hospital's Medicare contract in jeopardy | Join 78 hospital CEOs at Becker's CEO + CFO Roundtable | Calif. exchange insurers to drop in-network hospitals missing safety marks

May 22, 2018

• Aetna whistle-blower suspended after accusing CVS Caremark of $1B billing scheme | Wis. hospital at risk of losing Medicare contract | Oscar Health quietly built its own claims processor to simplify physician payments | BCBS drops North Carolina hospital from network after fraud allegations

May 17, 2018

• 5 things to know about $54B Cigna-Express Scripts merger | 100 great leaders in healthcare | BCBS of Massachusetts blames federal taxes for $97.2M operating loss | UnitedHealthcare denied a dying mother's liver transplant, until she penned a letter to the CEO

May 15, 2018

• Pa. hospital discloses Medicare billing violations | Trump says 'great health plans' to come in few weeks | Hear keynotes from NewYork-Presbyterian and Cleveland Clinic at Becker's Health IT + Revenue Cycle Conference | Texas hospital closes, allegedly owes Cigna and Aetna $43M

May 10, 2018

• Texas physician: BCBS' out-of-network ER policy will 'kill people' | UnitedHealthcare's bundled payment program cuts readmissions 22% | New York hospital reportedly pays CEO $660k to 'disappear' | Bon Secours, VCU Health partner for 4 ACA marketplace plans

May 8, 2018

• How Aetna, Anthem, Cigna, Humana and UnitedHealth fared in Q1 | Texas hospital to close | Join 210+ hospital and health system speakers at Becker's Health IT + Revenue Cycle conference | Partners explores merger with 1.2M-member health plan

May 3, 2018

• Humana's profit down 56%; Cigna's up 53% | Augusta Health CEO: Anthem is trying to strong-arm independent physicians | Hear Peyton Manning and Venus Williams at Becker's Health IT + Revenue Cycle Conference | California hospital to close, lay off 200 employees

May 1, 2018

• Aetna's net income swings to $1.2B | Humana divests 2 business lines to Texas insurer | Jury awards former Cleveland Clinic physician $28M+ in age discrimination case | Cigna CEO: 4 reasons we want to buy a PBM

April 26, 2018

• Anthem profits up 30% despite 1M drop in enrollment | CMS releases 2019 IPPS proposed rule: 10 things to know | BCBS of Texas may bill patients in full for nonemergent use of out-of-network ED | Humana to pay hospitals based on quality improvement

April 24, 2018

• Humana, 2 equity firms to acquire hospice operator for $1.4B | Penn State Hershey drops 2,100 neurology patients | Hear Cleveland Clinic CIO Ed Marx and 260+ speakers at Becker's Health IT + Revenue Cycle conference | HCA TriStar, BCBS dispute generates $14M in balance bills

April 19, 2018

• CMS terminates Kansas hospital's Medicare billing privileges | Piedmont, BCBS reach agreement after state ultimatum | DOJ to probe Cigna-Express Scripts deal | Aetna reorganizes business; will hire 250 in Mass.

April 17, 2018

• UnitedHealth profit jumps 30.6% | Henry Ford Health System's income dragged down by Epic implementation, labor costs | Join 78 CEOs and 22 CFOs from hospitals at Becker's 7th Annual CEO + CFO Roundtable | Georgia governor threatens executive action in BCBS-Piedmont dispute

April 12, 2018

• UnitedHealthcare dumps Envision contract | 150 top places to work in healthcare | Humana acquires Florida physician practice | Why Anthem could benefit from sitting out of health insurance deals

April 10, 2018

• With 8k more physicians than Kaiser, Optum is 'scaring the crap out of hospitals' | 5 changes under HHS' final payment rule | Join Kevin O'Leary and Alexa von Tobel at Becker's Health IT + Clinical Leadership conference | Judge: The way BCBS plans operate could automatically violate antitrust law

April 5, 2018

• CMS axes a Medicare Advantage star rating measure | Amazon vs. Walmart: Who has more power to change healthcare's landscape? | Microsoft sues CHS | Why a Pennsylvania woman's hospital bill spiked $393 after she proved her daughter was insured

April 3, 2018

• UnitedHealth's Optum, Humana + 3 others launch blockchain project | CHS continues hospital sell-off spree | Chicago Cubs President Theo Epstein to speak at Becker's 7th Annual CEO + CFO Roundtable | 5 reasons why a Walmart-Humana giant scares hospitals

March 29, 2018

• Anthem letter prompts Calif. hospital to shut down toxicology program | 10 best, worst states for physicians | UnitedHealth CEO: Tech will drive value-based care in 10 years | Allina Health, Aetna tap former Molina exec to lead joint health plan

March 27, 2018

• How some rural hospitals score huge paydays from insurance companies | 36 places make US News' first-ever community health honor roll | Hear Peyton Manning and Venus Williams speak at Becker's Health IT + Revenue Cycle conference | Cybersecurity team will 'lie, cheat and steal' to safeguard BCBS data

March 22, 2018

• UnitedHealth puts Envision's ED billing policies in its crosshairs | Humana reaches $2.5M settlement over alleged pay bias against 753 women | CHS seeks to terminate spinoff agreements amid feud with Quorum | FTC asks for more information on Optum's takeover of DaVita

March 20, 2018

• Aetna CEO advocates for return of healthcare 'to community' amid proposed CVS 'megadeal' | Wake Forest Baptist at risk of losing Medicare contract over cancer misdiagnoses | Hear Secretary Clinton at Becker's 7th Annual CEO + CFO Roundtable | UnitedHealth's Optum a 'favorable' differentiator from other insurers: Fitch

March 15, 2018

• BCBS-Lyft partnership to offer members 'no cost' trips to Walgreens, CVS | AHIP CEO to retire | Ascension Michigan lays off 500 hospital workers | UnitedHealth ditches bid for Envision's ambulatory services arm | 100 CMOs to know

March 13, 2018

• How health insurers game Medicare Advantage ratings to boost bonus payments | Amazon 'poaches' 20 jobs from CVS, Express Scripts, UnitedHealth | Registration nearly sold out for Becker's 16th Annual Spine Conference | 13 payer-provider contract disputes, resolutions | Optum to get new CEO

March 8, 2018

• Cigna to buy Express Scripts for $67B | UnitedHealth targets costly ED visits with new policy | 2nd Sparrow Carson executive departs amid infection control issues | 2 senators call on HHS secretary Alex Azar to probe Anthem's ED rules

March 6, 2018

• UnitedHealth spent $64B on value-based care in 2017 | 12 JV health plans formed since 2013 | Hear 200+ speakers at Becker's 4th Annual Health IT + Revenue Cycle Conference | Tenet continues hospital sell-off spree

March 1, 2018

• 4 Humana execs pocket $12M+ in stock sales | DOJ drops most of Medicare fraud lawsuit against UnitedHealth | Healthgrades names 'America's Best Hospitals' for 2018 | Google sister Verily to tackle health insurance

February 27, 2018

• Aetna CEO: CVS deal will open '10,000 new front doors to the healthcare system' | 35.8% of Americans would use an Amazon health insurance plan | Join 112+ speakers from hospitals and health systems at Becker's Health IT + Clinical Leadership 2018 | No pay raise for CHS CEO Wayne Smith in 2018

February 22, 2018

• Humana takes $148M hit from workforce cuts in 2017 | Ohio lawmakers want to discipline Anthem over ED policy | Amazon quietly launches exclusive OTC product line: 7 things to know | Medicaid managed care led to millions in compensation for one California couple: 5 things to know

February 20, 2018

• HHS proposes executive order loosening regulations on short-term plans | 3 more states investigating Aetna after former medical director's comments | Dr. Tom Price to join keynote panels at Becker's Health IT & Clinical Leadership conference | Anthem revises ER policy: 5 things to know

February 15, 2018

• BCBS of Idaho to sell 5 plans bypassing ACA rules: 6 things to know | Amazon pushes to become a major hospital supplier: 7 things to know | Ga. hospital group sues Anthem over new ER and imaging policies | Judge: DOJ's suit accusing UnitedHealth of $1B Medicare fraud can proceed

February 13, 2018

• Aetna's ex-medical director says he never reviewed patient records before denying care | 6 New Jersey health systems join forces to tackle insurance costs | Hear 200+ executives at Becker's Health IT + Revenue Cycle meeting | Molina's operating loss balloons to $269M

February 8, 2018

• Humana posts $184M profit in Q4 turnaround | Aetna sues mail handling firm for $20M over clear envelopes showing customers' HIV statuses | Protests scheduled at 32 Kaiser Permanente hospitals | UnitedHealthcare is using AI to personalize employer coverage: 3 things to know

February 6, 2018

• Disney partners with 2 Florida health systems to offer HMO plans | HCA acquires 612-bed Georgia hospital | 80+ sessions at Becker's Health IT + Clinical Leadership meeting | Anthem uses tax savings to give 58k employees $1,000

February 1, 2018

• Anthem's discretionary ED policy lands patient with $12k bill | Aetna CEO 'encouraged' by Amazon, JPMorgan and Berkshire Hathaway's joint company | CDC Director Dr. Brenda Fitzgerald resigns following stock controversy | Cigna's Q4 profits fall 30.4%

January 30, 2018

• Aetna's profit up 75.5% in Q4: 3 things to know | State-by-state breakdown of 83 rural hospital closures | Join 112 speakers at Becker's Health IT + Clinical Leadership meeting | UnitedHealth, others see stocks plunge after Amazon, JPMorgan, Berkshire Hathaway unveil collaboration

January 23, 2018

• Anthem at center of Augusta Health petition with 3,700+ signatures | BCBS of Michigan lays off 70 | Hear Venus Williams and Peyton Manning speak at Becker's 4th Annual Health IT + Revenue Cycle conference | Allscripts recovers after ransomware attack: 10 things to know

January 18, 2018

• Aetna investor sues over $77B CVS Health merger: 7 things to know | UnitedHealth will gain $1.7B in 2018 under new tax law | CHS aims to shed at least 20 more hospitals to reduce debt load | Humana faces backlash for hiking breast cancer drug copays

January 16, 2018

• UnitedHealth's profits more than double in Q4 | MedPAC votes to kill MIPS, recommends alternative program | Join 3,500+ attendees and 320+ speakers at Becker's 9th Annual Hospital Review Meeting | Molina to eliminate COO role

January 11, 2018

• Humana leaves AHIP: 4 things to know | NYC cancels Aetna's $9.6M incentive to move HQs | 6 things to know about CMS' new bundled payment model | Cigna unit lays off 60 employees

January 9, 2018

• Highmark, UPMC to extend in-network access to 10+ hospitals | Trump moves to allow health insurance sales across state lines: 3 notes | Join presidents George W. Bush and Bill Clinton at Becker's 9th Annual Hospital Review Meeting | Lawsuit: 8-inch forceps left inside woman after surgery at Calif. hospital

January 2, 2018

• Anthem to cut payment for some same-day services by 25% | 337 hospitals with 5 stars from CMS | Sign up for Becker's Health IT + Clinical Leadership conference today | UnitedHealth, OptumRx defeat lawsuit over alleged prescription drug scheme

December 26, 2017

• UnitedHealth to acquire Chilean healthcare firm for $2.8B | 92 payer-provider disputes, agreements | 275+ executives to speak at Becker's 9th Annual Hospital Review Meeting | Moody's: 3 ways the GOP tax overhaul will hurt nonprofit hospitals

December 19, 2017

• Humana, equity firms to buy Kindred for $4.1B | Centene unit hit with $500k fine over narrow network plans | Tenet closes 232-bed Phoenix hospital | BCBS subsidiary to lay off 264 employees after losing Medicare contract

December 12, 2017

• How 8 top payers would benefit under Republicans' tax bill | 10 healthiest, unhealthiest states | Ascension, Providence St. Joseph in talks to merge, dethrone HCA as largest hospital operator: 5 takeaways | Physicians argue Anthem's ER policy violates federal law

December 5, 2017

• CVS Health to acquire Aetna for $69B: 5 things to know | Police take down gunman at Calif. Hospital | Medicaid, Medicare reflect 59% of revenue for 5 largest commercial insurers | 8 payer-provider disputes, resolutions

November 28, 2017

• UnitedHealth's Optum launches $250M venture fund | Humana updates severance policy for 'change in control,' stoking M&A rumors | Ex-WellCare general counsel gets prison time for role in $35M fraud scheme | Is a Medicare option for all the only practical means to solve the healthcare insurance crisis?

November 21, 2017

• CVS-Aetna deal could arrive this month | Anthem, Cigna face multimillion dollar fines | Sutter Health destroys evidence in antitrust case over inflated prices | UnitedHealth's Optum finalizes $1.3B bid with Advisory Board

November 14, 2017

• Aetna CEO: Taking on Apple's business model a 'real deal' | How Aetna, Anthem, Humana, Cigna and UnitedHealth fared in Q3 | CHS to sell additional hospitals worth $2B in revenue | 8 payer executive moves

November 7, 2017

• Humana reveals 1,300 employee layoffs; sues CMS for $600M+ | Anthem's CEO to step down | Epic's software double-bills Medicare, Medicaid for anesthesia services: lawsuit | 'An Optum wannabe': Experts say UnitedHealth, more than Amazon, fueling CVS-Aetna deal

October 31, 2017

• Aetna gets $66B bid from CVS Health; sees net income jump 39% | Top 10 MSSP ACOs in 2016 shared savings | Calif. hospital closes, 524 employees face layoffs | 17 payer-provider disputes, resolutions

October 24, 2017

• Centene's revenue climbs nearly 10% | Los Angeles hospital to close, lay off 638 employees | Aetna to spin off life, disability business for $1.45B | Insurers' No. 1 worry right now: Consumer confusion

October 17, 2017

• UnitedHealth revenue up 9%, but offset by ACA exchange exit | How Pioneer, Next Gen ACOs fared in 2016 | Mississippi hospital will charge $200 upfront fee for nonurgent ED visits | 4 things to know about the health insurance industry

October 10, 2017

• Hartford HealthCare sues Anthem over emergency services reimbursement arrangement | BCBS subsidiary issues layoffs | Physician assistant median salary for all 50 states | Judge tosses lawsuit accusing UnitedHealth of overbilling Medicare

October 3, 2017

• 5 CHS hospitals lose in-network status from Independence Blue Cross in Tower Health deal | Anthem exec to helm Optima Health | Tennessee hospital closes after falling 94% short of GoFundMe goal | 17 health plans ranked by consumer experience

September 26, 2017

• Humana launches early retirement program | Anthem's new outpatient imaging policy at odds with promoting quality, critics say | Wisconsin health system blames Cerner software for $16M in losses | 112 physician leaders to know

September 19, 2017

• Aetna, Vanderbilt Health launch ACO product | 10 states with the highest, lowest uninsured rate | CHI's operating loss swells to $585.2M in FY 2017 | Centene to absorb Fidelis in $3.75B deal

September 12, 2017

• Cutting cost-sharing reductions may inflate uninsured by 9.4M | Missouri hospital at risk of losing Medicare funding | 3 M&A trends in the payer services market | BCBS of Louisiana CMO on his leap from emergency medicine, health IT to payer leadership

September 5, 2017

• Humana to lay off 180 | 6 payer exec moves | Tenet to replace CEO Trevor Fetter, 'refresh' board and adopt poison pill | 35 ways to help Harvey recovery

August 29, 2017

• Optum buys Advisory Board's healthcare arm in $1.3B deal | Northwell Health to shut down insurance business | How Texas hospitals are faring amid Hurricane Harvey's catastrophic flooding | 7 ways insurers are countering the opioid epidemic

August 22, 2017

• 'Project X': Boston's $16M effort to woo Aetna | Mission Health: BCBS' removal of providers from online directory 'overt and senseless action' | Tenet board upheaval could lead to activist campaign | 110 ACOs to know

August 15, 2017

• CMS will cancel major bundled payment initiatives | 23 payers proposing double-digit premium hikes | Deadline to price ACA marketplace plans delayed 3 weeks | Aetna may offer customers Apple Watches

August 8, 2017

• Molina owed $52M in risk corridors payments | 5 latest payer, provider contract disputes, resolutions | CMS to punish more than 2.5k hospitals for 30-day readmissions | How Aetna, Anthem, Cigna, Humana and UnitedHealth performed in Q2

August 1, 2017

• Anthem email breach hits 18k members | 18 payer-provider disputes, resolutions | Man accused of killing physician over botched prostate surgery 21 years prior | 15 key dates for 2018 open enrollment

July 25, 2017

• Molina Healthcare to slash about 1,400 jobs | Mission Health pens op-ed on BCBS impasse | HCA acquires second hospital from CHS in 2 weeks | 3 analytics tips to amplify policyholder engagement

July 18, 2017

• UnitedHealth Q2 earnings spike 30% | 4 health systems on the brink of dropping payers | CMS releases OPPS proposed rule for 2018 | 'Junk insurance' - healthcare's latest dreaded term

July 11, 2017

• Anthem expands discretionary ED coverage to Missouri | UnitedHealth may buy Advisory Board's healthcare division | Cerner CEO Neal Patterson dies from cancer complications | 'Accept Cigna' featured on Florida physician's state legislature campaign sign

July 5, 2017

• UnitedHealthcare invests $18.3M in affordable housing | 6 payer-provider joint health plans established this year | Cleveland Clinic CEO: BCRA will put hospitals in 'very deep financial trouble' | Aetna to move to NYC