Legislation aiming to reform the Medicare Advantage prior authorization process has the backing of 389 national and state organizations, ranging from the American Hospital Association to Humana.
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The majority of ACA marketplace plans cover GLP-1 drugs approved for diabetes, though fewer than 1% of plan formularies include drugs solely approved to treat obesity, a new analysis from KFF shows.
CMS has recalculated Medicare Advantage plans' star ratings after insurers challenging the agency's methodology were handed court victories.
CMS closed its suburban Baltimore headquarters on June 7 after Legionella bacteria was detected in the facility's plumbing amid renovations, The Washington Post reported June 13.
Here are five lawsuits, settlements and legal developments involving payers that Becker's has reported since May 22:
Optum's former senior vice president of AI products and platforms Sanji Fernando has joined healthcare-focused private equity firm Frazier Healthcare Partners.
Blue Shield of California snagged a contract managing care for 400,000 California state employees.
From Kraft Heinz suing Aetna for alleged mismanagement of employee claims data to Elevance Health being sued by contracted labor unions for reportedly restricting claims data access, certain third-party health plan administrators are being forced to answer the big questions…
CMS is conducting a review of Texas' Medicaid enrollment backlogs.
A generic medication from CivicaScript saved Highmark members $90 per month on average and generated $3 million in savings for the plan, members and group customers, the insurer said in a May 29 news release.