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CMS innovation center did not save money in its 1st decade: CBO
The CMS innovation center tasked with creating innovative payment models cost the government more money than it saved in its first decade, a report from the Congressional Budget Office found. -
UCare taps SSM Health-Costco PBM for pharmacy benefits
UCare has selected Navitus Health Solutions, a pharmacy benefit manager owned by St. Louis-based SSM Health and Costco, to administer pharmacy benefits to its more than 600,000 members across all lines of business, effective Jan. 1. -
11 payers among the greatest places to work for parents and families
Eleven payers have been named among Newsweek's 2023 America's Greatest Workplaces for Parents and Families. -
Medicaid in the headlines: 9 recent updates
HHS paused Medicaid enrollments in 30 states reporting issues with their automatic renewal systems, and some states are enacting or considering Medicaid expansion. -
COVID-19 vaccine coverage issues resolved, payer execs say
Private insurers are covering the full cost of COVID-19 vaccines for beneficiaries this fall, payer executives told HHS Secretary Xavier Becerra. -
How health plans can realize quick operational wins with modern working and automation
Health plan operations are full of repetitive work cycles and tasks requiring highly specialized knowledge. How do you ensure your tools and processes reduce no- or low-value activities and unlock the capacity for employees to focus on more thoughtful work? -
OIG: 4 states received increased Medicaid funding despite unallowable terminations
Four states received increased federal Medicaid funding during the COVID-19 pandemic, though they may have terminated beneficiaries' coverage in violation of continuous coverage rules in place during the public health emergency, an audit by HHS' Office of Inspector General found. -
UCHealth Plan Administrators joins Intermountain's Select Health
UCHealth Plan Administrators is joining Select Health, the nonprofit insurance arm of Salt Lake City-based Intermountain Health that serves more than 1 million members across Utah, Idaho and Nevada. -
Medicare Advantage premiums to remain stable in 2024
Medicare Advantage and Medicare Part D premiums, benefits and plan choices won't be changing much in 2024, CMS said Sept. 26. -
Cano Health sells Texas, Nevada primary care centers to Humana for $66.7M
Miami-based primary care provider Cano Health is selling the bulk of its centers in Texas and Nevada. -
Cigna to pay $150K to settle alleged Virginia billing violation
Cigna agreed to pay $150,000 to settle allegations from the Virginia Bureau of Insurance that it violated state law by failing to provide required balance billing disclosures. -
What 1 Aetna regional president recommends for successful value-based arrangements
Building and maintaining successful value-based care arrangements is difficult and will require innovative thinking from leaders across the healthcare spectrum, according to Aetna's Southeast region president, Rich Weiss. -
Lawsuits pile up against Cigna over alleged mass claim denials
The Cigna Group is facing a growing number of lawsuits from members and a shareholder following a ProPublica report that alleges the company denies large batches of members' claims without individual review, thereby denying them coverage for certain services. -
Lawmakers propose bill to automatically enroll children in Medicaid
Proposed legislation would automatically enroll all children under age 18 in Medicaid. -
6 payers exiting markets
As several payers plan market expansions for 2024, others are leaving markets behind. -
Medicare Advantage in the headlines: 8 recent updates
The National Committee for Quality Assurance has named the top Medicare Advantage plans of 2023, and new research is uncovering cost differences between MA and traditional Medicare. -
The most popular TV shows for Medicare Advantage ads
In 2022, viewers tuning into "Dr. Phil" saw an average of eight ads for Medicare Advantage plans per episode during open enrollment season, according to an analysis from KFF. -
North Carolina expanding Medicaid Dec. 1
North Carolina will launch its Medicaid expansion program Dec. 1, which is expected to provide more than 600,000 state residents with coverage. -
How Blue Cross North Carolina is bucking rising costs in the ACA market, per its CFO
Health insurers across the country are looking to raise premiums for individual exchange plans in 2024, with many proposing double-digit increases. In contrast, Blue Cross and Blue Shield of North Carolina says its members will see individual rates go down by an average of 4 percent next year. -
Kansas governor says Medicaid expansion the 'top priority' for 2024
Kansas Gov. Laura Kelly has launched a statewide campaign pushing for Medicaid expansion, calling it her top priority for the state's legislative session next year.
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