A package of California bills aiming to streamline the prior authorization process recently passed out of Senate and Assembly health committees, the California Medical Association said April 28. The four-bill “Prioritizing Patients, Empowering Physicians” package was unveiled April 10 by…
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Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Akron Children’s Hospital seeks a director of reimbursement and payer analysis. 2. Albany…
Priority Health, the insurance arm of Grand Rapids, Mich.-based Corewell Health, has named Nick Gates as interim president, effective May 1. He succeeds Praveen Thadani, who made the decision to step away from the role, according to a news release…
Nashville-based Meharry Medical College has purchased eight medical clinics from a joint venture between BlueCross BlueShield of Tennessee and Sanitas. The clinics, located in Nashville and Memphis, currently serve a total of 25,000 patients and employ 40 providers, according to…
For payers, drug formulary development and maintenance are essential for accurate reporting and tracking of prescription medications. An up-to-date and well-established classification resource can help payers and other stakeholders manage their drug formulary more efficiently. While several classification resources are…
2025 is shaping up to be a rocky year for payers’ finances. At least seven Blue Cross Blue Shield plans reported losses in 2024, which could persist into 2025. In April, UnitedHealth Group cut its earnings guidance for 2025, citing…
A former Centene executive is suing the company over what he called “wrongful, anti-competitive, and bullying behavior” related to a noncompete agreement. The plaintiff, who served as vice president of pharma relations and business strategy at specialty pharmacy AcariaHealth (acquired…
One in three Americans receives health coverage through one of 33 independent Blue Cross Blue Shield companies. Here are 101 things to know about BCBS’ corporate structure, history and more. This story was first published in April 2023 and last…
A federal judge has dismissed a proposed class-action lawsuit that aimed to require insurers in New Mexico to cover medical cannabis as a behavioral health treatment. The complaint was originally filed in June 2022. On April 23, U.S. District Judge…
Chiquita Brooks-LaSure, the CMS administrator under the Biden administration, is joining the board of directors for Families USA, a health consumer advocacy organization. Ms. Brooks-LaSure will help guide the organization’s efforts to advance health justice and economic security, including defending…