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Payer Issues

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 11, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Aetna loses court battle over 'all or nothing' mental health coverage Full story 2. Life expectancy by state: CDC Full story 3. 'Big 6' payer membership by the…

'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 10, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 'Big 6' payers ranked by 2021 revenue Full story 2. US COVID-19 hospitalizations drop below 100,000 — 3 states where they're still rising Full story 3. Biden…

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 9, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Blue Cross CFO, former Nike exec join Providence board Full story 2. New Mexico payer sued over 63,000 member data breach Full story 3. CVS Health year-end revenue…

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 8, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Centene hits $126B in 2021 revenue, up 13%: 10 things to know Full story 2. PBMs ranked by market share: CVS Caremark is No. 1 Full story 3.…

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 4, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Kaiser Permanente's special California Medicaid contract raises concerns Full story 2. Viewpoint: At-home COVID-19 test coverage gives providers 'unchecked power' over payers Full story 3. SCAN…

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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 3, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. UnitedHealthcare subpoenaed over Rhode Island data breach Full story 2. Will BA.2 impact omicron forecasts? 3 modeling takeaways Full story 3. Despite revenue growth, Cigna year-end profit dips…

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 2, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Humana's 2021 net income dips 27%, sets $1B value creation goal Full story 2. Union accuses HCA of widespread Medicare fraud in 45-page report Full story 3. This…

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

February 1, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. California universal healthcare bill dies before key vote Full story 2. Judge extends Northside-Anthem contract until April 15 Full story 3. GuideWell closes $900M Triple-S acquisition, brings enrollment…

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 28, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Cancer patients win lawsuit against Aetna over denied treatment Full story 2. CHS owes fees in $98M fraud case, court rules Full story 3. Humana balked at…

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 27, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Cigna discussed potential acquisition with Centene in late 2021 Full story 2. Next variant could be more transmissible than omicron, WHO says Full story 3. Pharmacist gets 5-year…

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