• Top 10 health insurance stories of 2023

    From the start of Medicaid redeterminations to short-lived megamergers, these are the 10 most read health insurance stories reported by Becker's in 2023:
  • 5 recent payer lawsuits, settlements

    From CareFirst suing Johnson & Johnson over alleged anticompetitive biosimilar tactics to Humana accused of using an AI tool to wrongfully deny Medicare Advantage claims, here five lawsuits, settlements and legal developments involving payers that Becker's has reported since Dec. 5:  
  • Medicaid in the headlines: 7 recent updates

    HHS urged nine states to do more to keep eligible children enrolled in Medicaid, and more states are considering Medicaid work requirements. 
  • Humana's 2023 in 10 headlines

    In 2023, Humana announced plans to end its commercial insurance business, named its next CEO and saw a planned merger with Cigna fall through. 
  • 4 Medicaid work requirement updates

    From the continued slow start of Georgia's program to the Kansas governor's "middle of the road" proposal, here are four state Medicaid work requirement updates Becker's has reported on since Dec. 19: 
  • Elevance Health's 2023 in 10 headlines

    Elevance Health named new leadership, planned acquisitions and settled lawsuits in 2023. 
  • UnitedHealth's 2023 in 10 headlines

    From expanding its Medicare Advantage offerings to cutting 20% of prior authorization requirements, these are the 10 most read stories about UnitedHealth Group published by Becker's in 2023:
  • The 10 biggest Medicare Advantage stories in 2023

    2023 was an eventful year for Medicare Advantage. 
  • Aetna's 2023 in 10 headlines

    In 2023, Aetna, like many other payers, laid off employees. The insurer also snagged a big contract in North Carolina, and had another multibillion dollar contract blocked in New York City. 
  • 10 prior authorization updates to know in 2023

    Several payers, including UnitedHealthcare and Cigna, announced prior authorization cuts in 2023. Here is more on that and other prior authorization updates Becker's reported this year:
  • Payer-provider collaboration and the future of value-based care: Four roundtable takeaways and quotes

    During an interactive session at Becker's Payer Issues Roundtable, leaders from WNS — Asheesh Tiwari, Corporate Vice President, Markets & Growth for Healthcare and Life sciences and Anand Jha, Corporate Vice President, Digital Transformation, Healthcare and Life Sciences and supported by Dr. Ronald Lopez, CMO, HealthHelp, A WNS Company, led a group of healthcare executives in a discussion about the challenges and opportunities in value-based care. 
  • Kansas governor's 'middle of the road' Medicaid expansion proposal

    Kansas Gov. Laura Kelly has tried unsuccessfully for years to expand Medicaid in the state and now has a new "middle of the road" plan that includes work requirements, NPR affiliate KCUR reported Dec. 18. 
  • Feds want Humana's Medicare Advantage clawback lawsuit thrown out

    The Justice Department wants Humana's lawsuit challenging a CMS rule that would implement stricter auditing standards on Medicare Advantage plans moved to a different court, then thrown out. 
  • Payers are hiring physicians with histories of malpractice: Report

    Some of the nation's largest health insurers employ or employed physicians who have a history of malpractice or have been reprimanded by state medical boards, according to a Dec. 15 report from ProPublica and The Capitol Forum.
  • Medicare Advantage in the headlines: 10 recent updates

    Humana is the latest insurer facing a lawsuit over allegedly using automated tools to deny Medicare Advantage members' claims, and Molina expects its acquisition of Bright Health's Medicare Advantage business to close soon. 
  • HHS scolds 9 states with highest childhood Medicaid disenrollment rates

    HHS is urging states to do more to prevent eligible children from being disenrolled from Medicaid coverage. 
  • State health plans decry weight loss drug costs for employees

    North Carolina, Connecticut and Delaware's employee health plans are all grappling with how to cover the high cost of weight loss drugs, with each implementing limitations around coverage of the expensive medications.
  • CareFirst sues J&J over alleged anticompetitive biosimilar tactics

    CareFirst BlueCross BlueShield has filed a proposed class-action lawsuit accusing Johnson & Johnson and Janssen Biotech subsidiary of unlawfully delaying the introduction of biosimilar competition for ustekinumab. 
  • South Dakota lawmakers reintroduce Medicaid work requirement proposal

    A pair of South Dakota lawmakers are seeking to put a ballot issue in front of voters in 2024 on whether the state should consider work requirements for those enrolled in the expanded Medicaid program, the Argus Leader reported Dec. 15. 
  • Why direct contracting, 'payviders' will become more prominent

    While the world of healthcare remains ever changing, Seattle, Wash.-based First Choice Health, a provider and hospital-owned healthcare company, is looking to expand its network footprint in 2024. 

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