November 20, 2023 BHR Newsletter 1. 3 payer CEOs among healthcare's 'most overpaid' Full story 2. Texas pharmacy owners, physician convicted in $145M fraud scheme against BCBS, Labor Dept. Full story 3. Tennessee extends Medicaid contracts without Centene Full story…
Payer Issues
November 17, 2023 BHR Newsletter 1. CMS pitches new regulations for state-run exchanges: 5 things to know Full story 2. 4 payers entering Medicare Advantage in 2024 Full story 3. 7 prior authorization updates Full story 4. Tufts and SSM…
November 16, 2023 BHR Newsletter 1. Justice Department dropping antitrust case against UnitedHealth's SCA Health Full story 2. Hospitals are dropping Medicare Advantage left and right: 13 updates Full story 3. 11 payer executive moves since Nov. 1 Full story 4.…
November 15, 2023 BHR Newsletter 1. UnitedHealth faces lawsuit over AI, Medicare Advantage care denials Full story 2. 5 states considering adding weight loss drug coverage under Medicaid Full story 3. Froedtert purchases Ascension's stake in health plan Full story…
November 14, 2023 BHR Newsletter 1. 'Audits are increasing': Feds ramp up Medicare Advantage scrutiny Full story 2. Intermountain's health plan aims to end PBM 'games' through Cuban partnership Full story 3. AMA calls on insurers to cover weight loss…
November 13, 2023 BHR Newsletter 1. BCBS Association sued over alleged disclosure of federal employee data to TikTok Full story 2. CMS proposes new Medicare Advantage audit appeals process Full story 3. New York payer laying off 68 employees Full…
November 10, 2023 BHR Newsletter 1. 15 payers cutting jobs Full story 2. Former Optum employee to pay $13M for role in fraud scheme Full story 3. CMS imposes hiring freeze Full story 4. Learn how Group Health carriers are…
November 9, 2023 BHR Newsletter 1. 14 insurers exiting Medicare Advantage in 2024 Full story 2. 7 Optum-owned clinics shuttered in Florida, Minnesota Full story 3. 23 payer executives' top priorities for 2024 Full story 4. Prisma Health + BCBS…
November 8, 2023 BHR Newsletter 1. CMS proposes health equity mandates for Medicare Advantage prior authorizations Full story 2. Elevance settles noncompete case with former exec who left for Molina Full story 3. 'Flagrant disregard of the law': Nebraska revokes…
November 7, 2023 BHR Newsletter 1. CMS proposes more crackdowns on Medicare Advantage marketing, broker payments Full story 2. Why Orlando Health became Walmart's 1st hospital partner Full story 3. Cigna reportedly considering selling Medicare Advantage business Full story 4.…
