Anthem Blue Cross Blue Shield is requesting payments from some providers it alleges falsified patients' medical records when prescribing Ozempic, Bloomberg reported Sept. 12.
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Cigna is launching an "E-Treatment" option to allow members to get urgent care without any direct video or phone interaction with a provider.
In an industry often criticized for its opacity, healthcare is undergoing a significant shift thanks to the CMS’s 2020 Transparency in Coverage ruling, which requires insurers and Payers to disclose the rates they negotiate with healthcare providers via detailed breakdowns…
Elevance Health was ranked no. 3 on Fortune's list of the "Best Large Workplaces in Healthcare."
Editor's note: This story was updated Sept. 12 to reflect that the Arizona Health Care Cost Containment Systems upheld its original contract awards. Arizona will uphold contracts awarded to UnitedHealth and Centene to manage the state's long-term care Medicaid program.
Bonus payments to Medicare Advantage plans will decline by around 8% in 2024 compared to 2023, according to a report from KFF.
UnitedHealthcare and Humana are expected to collectively receive 50% of total Medicare Advantage star bonus payments in 2024, while Kaiser Permanente is expected to collect the highest average bonus per enrollee ($516), according to a Sept. 11 analysis from KFF.
Aetna is facing a class-action lawsuit alleging the insurer improperly denied gender-affirming care.
CMS is suspending new enrollment for a Centene Medicare Advantage subsidiary in Missouri after the company failed to meet the required medical loss ratio for three years in a row.
Optum Rx will join the other major pharmacy benefit managers and exclude Humira from some formularies.