Tricare Prime Demo by CareSource Military and Veterans is coming to Tampa, Fla., and Atlanta next year. Through the Department of Defense, Tricare offers health plans to uniformed service members, retirees and their families. CareSource Military and Veterans President Holly…
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This year, Elevance Health began covering doula care for members of some employer-sponsored health plans. Cynthia Brown, MD, medical director and clinical lead for women’s health at Elevance Health, joined the Becker’s Payer Issues podcast for an upcoming episode on…
A Florida bill aims to establish a marketplace for employees to use their premium contributions through individual coverage health reimbursement arrangements. The bill would build on the state’s former health insurance marketplace, modifying the name to the Florida Employee Health…
Senate Democrats are introducing legislation to extend enhanced premium ACA tax credits by three years, according to Senate Minority Leader Chuck Schumer. The bill would come to the Senate floor for a vote Dec. 11, “and every single Senate Democrat…
More than half of ACA marketplace enrollees would be likely to pick up extra work if healthcare costs increase by $1,000 per year, a Dec. 4 KFF analysis found. With enhanced tax credits set to expire at the end of…
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Two New York state lawmakers are pressing the state’s health department to investigate UnitedHealth Group’s physician practice arm, Optum, according to a Dec. 3 report from Mid Hudson News. New York state Sen. Peter Harckham and Assemblyman Matt Slater called…
The U.S. Government Accountability Office found significant fraud risk in the ACA application process, according to a Dec. 3 agency report. Auditors applied for coverage under fictitious identities to test marketplace enrollment controls. The marketplace approved coverage for the four…
Aetna is bundling pharmacy prescriptions and medical procedures into a single clinical review, according to a Dec. 4 news release. Providers previously had to submit two prior authorizations, but, as of November, providers only have to file one medical review,…
The 12 months since UnitedHealthcare CEO Brian Thompson was fatally shot have been among the most turbulent in UnitedHealth Group’s history. The company has cycled through senior executives, disclosed billions in unexpected medical costs, confirmed it is under criminal investigation…
At the Fall 2025 Becker’s Payer Issues Roundtable, industry leaders explored how clinical intelligence and digital transformation are redefining the payer-provider relationship. The session, titled “From Policy to Payment: Clinical Intelligence Driving Health Plan Innovation,” featured Andrea Willis, MD, senior…