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Payer Issues

Insurers prep for great 2023 coverage shuffle | CMS unveils 340B pay plan | Pfizer eyes $110 COVID shot price tag | 20 top hospitals' payer mix | Providence Health Plan's CEO on building a plan everyone wants

October 21, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Payers prep for the great 2023 shuffle from Medicaid to ACA coverage Full story 2. CMS unveils 340B hospital payment plan after court battle Full story 3. Pfizer eyes $110 COVID…

UnitedHealthcare names Calif. CEO | DOJ wants info on CVS' Signify buy | AMA, AHA challenge surprise billing arbitration, again | Centene jumps into Ga. politics | CareFirst loses DC Medicaid bid | Where 5 payers are reforming prior authorization

October 20, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Regulators seek more info on CVS acquisition of Signify Health Full story 2. AMA, AHA, state medical groups challenge feds — again — over surprise-billing rule Full story 3. UnitedHealthcare names…

Mark Cuban's pharmacy, Vivio partner on specialty drugs | Elevance's $1.6B Q3 | UnitedHealth, Duke spar over Medicaid contract | The largest PBM in each state | UnitedHealth Group expands behavioral network 25% | 12 payer partnerships

October 19, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Elevance Health's $1.6B Q3 Full story 2. Mark Cuban's online pharmacy, Vivio partner on specialty drugs for health plans, employers Full story 3. The largest PBM in every state Full story 4. 35%…

Apple to take up health insurance | The rise + fall of COVID billionaires | DOJ sues Cigna for alleged MA fraud | For payers, addition by COVID subtraction | Updates on Medicaid shakeup in Calif. | The largest payer in each state

October 18, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Apple reportedly launching health insurance in 2024 Full story 2. Lawsuits, challenges and debates: Where California's controversial Medicaid contract process stands Full story 3. 'False and invalid diagnoses': DOJ sues Cigna…

UnitedHealth spending $100M on Change integration | Bill would ban 'Advantage' from Medicare | Optum, UCLA partner on AI | Walmart to sell OTC hearing aids | Best MA plans of 2022 | 14 payers entering, exiting markets

October 17, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. UnitedHealth Group spending $100M to integrate Change Healthcare Full story 2. Progressive lawmakers want to ban payers from selling Medicare Advantage plans under Medicare name Full story 3. Best Medicare Advantage…

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UnitedHealth's $5.3B Q3 | COVID emergency renewed amid mixed signals | CMS to release MA audits after lawsuit | Valley Health sues Anthem Va. over provider rates | Bright Health's insurance exit effects Colo. reforms | CMS extends bundled payment pilot

October 14, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. UnitedHealth Group's $5.3B third quarter Full story 2. HHS renews COVID-19 PHE for 11th time — here's why Full story 3. CMS to release Medicare Advantage audits in response to media lawsuit Full…

CommonSpirit confirms ransomware hit | Bright Health's troubled 2022 | How big payers fared in CMS' MA star ratings | BCBS boosting federal employee benefits | Va. building its own insurance exchange | Meet the BCBS CEO in every state | 11 Aetna headlines

October 13, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. CommonSpirit Health confirms ransomware attack Full story 2. Exits, layoffs and losses: Bright Health Group's troubled 2022 Full story 3. Meet the CEO of the BCBS affiliate in every state Full story…

ACA family glitch fix finalized | How payers have exploited MA | Home Depot appeals $2.7B BCBS settlement | BCBS Miss., UMMC end talks | CommonSpirit's big IT problems | Why MA star ratings went down | Morgan Health seeks commercial insurance researcher

October 12, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. How payers have exploited Medicare Advantage Full story 2. Biden's 'family glitch' fix kicks in soon  Full story 3. Home Depot among objectors of $2.67B BCBS antitrust settlement Full story 4. Get…

Bright Health ends individual, group business | Blue Shield Calif. sues state over Medi-Cal contracts | CMS' 5-star MA plans | CVS in exclusive talks to buy Cano | TPG Capital buys ClaimsXten for $2.2B | Priority Health, Kroger launch Medicare plan

October 11, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Bright Health to end individual and group insurance business Full story 2. Blue Shield of California files lawsuit seeking public records in Medi-Cal dispute  Full story 3. CMS' 5-star Medicare…

Avg. MA star rating falls | Payers send members to Mark Cuban's pharmacy | Optum's ownership of Kelsey-Seybold: 5 notes | Elevance facing MA fraud suit from DOJ | OIG: BCBS Tenn., Inter Valley owe millions in overpayments | Meet the BCBS CEOs in the West

October 7, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Payers are steering their members to Mark Cuban's pharmacy Full story 2. CMS: Average 2023 Medicare Advantage star rating decreasing Full story 3. 5 things to know about UnitedHealth Group's ownership…

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