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Payer Issues

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 14, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Cleveland Clinic helps family appeal to New York state after Empire BCBS denies multi-organ transplant Full story 2. Federal jury convicts New York man in $600M billing fraud scheme Full…

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 13, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Northside Hospital, Anthem settle on contract after legal dispute Full story 2. Florida puts $3.1B state employee health plan up for bid Full story 3. Former Elevance CEO joins board of…

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 12, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. How to launch a PBM, Mark Cuban style Full story 2. Top Optum tech exec heads to Burger King's C-suite Full story 3. UNC flagship hospital's Medicare contract in jeopardy Full…

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 8, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. FTC reportedly seeking employee wage information for proposed LHC Group, UnitedHealth deal Full story 2. Biden to take executive action to protect abortion access Full story 3. CMS pitches physician payment…

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 7, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Alec Baldwin Instagram post spurs Anthem BCBS to cover Virginia teacher's spine surgery Full story 2. Senate Democrats advance plan to give Medicare drug price negotiation powers: 6 notes Full…

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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 6, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 5 top execs that have recently left Optum  Full story 2. Payers are looking to expand Medicare Advantage markets despite increased scrutiny Full story 3. The key drivers of change…

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 5, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. The caveat of payers' current posted prices Full story 2. Cigna, Aetna among payers that will cover employees' abortion travel costs Full story 3. NorthShore University Health called in 20 physicians…

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

July 1, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Payers must post negotiated prices starting today: 8 things to know Full story 2. 25 payer exec moves in June Full story 3. Top 15 health systems of 2022, per Fortune,…

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 30, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Watchdog groups to Congress: Crack down on Medicare Advantage plans Full story 2. Police kill armed patient at Baylor Scott & White hospital Full story 3. Top UnitedHealth Group legal exec…

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 29, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Meet Elevance Health's executive team Full story 2. California fines Molina $1M for slow provider payments Full story 3. Hospital group wants prompt payment of 340B funds after Supreme Court win Full…

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