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Payer Issues

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

December 1, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. New Jersey school board sues Horizon, says insurer threatened to stop paying claims for 14,000 workers Full story 2. Insurance manager fined $1M for selling illegal plans in Washington Full…

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 25, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. UnitedHealthcare delays coding changes for lab tests Full story 2. HCA defeats whistleblower's billing fraud suit Full story 3. Should the US blame high healthcare spending on fee-for-service? Maybe not,…

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 24 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Cigna leadership used covert tactics to 'blow up' $48B Anthem deal, lawsuit claims Full story 2. How the White House's new drug-pricing rules affect health insurers Full story 3. New…

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 19, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. BCBS of North Carolina extends COVID-19 cost-sharing waivers, virtual visit payment into 2021 Full story 2. Cigna, Health First may end relationship if agreement not reached Full story 3.…

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 18, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. US daily death toll highest since May; Pfizer's vaccine 95% effective — 7 COVID-19 updates Full story 2. UnitedHealth: Move routine imaging out of hospital, lower spending by 62%…

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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 17, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Kaiser pays $6.4M to settle false claims allegations Full story 2. Fitch: 5 long-term financial trends for health insurers Full story 3. COVID-19 surges in 48 states; US hits…

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 12, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Ohio hospital files antitrust suit against ProMedica Full story 2. Hospitalizations rise for 18th day; developmental disorders tied to 3x higher COVID-19 death risk — 4 updates Full story…

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 11, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. COVID-19 hospitalizations hit all-time high; CDC takes stronger stance on masks — 6 updates Full story 2. Chicago nurses placed on leave after delivering dead flowers to…

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 10, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Cigna refused to cover COVID-19 testing, lawsuit alleges Full story 2. Meet the 13 members of Biden's COVID-19 task force Full story 3. US sees 6th day with 100K+…

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 5, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. UnitedHealth ordered to reprocess 67,000 mental health claims Full story 2. US hits 100K+ daily cases for 1st time; PPE strains felt nationwide — 4 COVID-19 updates Full story 3. Tennessee…

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