Bloomington, Minn.-based HealthPartners and Quartz are working together on self-funded health plan options for employees. Large, commercial employers across Minnesota and Wisconsin will have coverage options that offer robust administrative resources, as well as strong regional and national provider networks.…
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CMS proposed its 2027 Medicare Advantage and Part D capitation rates and payment policies Jan. 26, putting forth a slowdown in payment growth after a $25 billion boost for 2026. Six things to know:
Settling into 2026, prior authorization continues to be a contentious topic for payers, providers, lawmakers and other leaders. From piloting prior authorization in Medicare to governors pitching reforms, this year is already featuring major shifts. Here are seven prior authorization…
Dane Street is now certified as a federal independent dispute resolution entity, CMS said in a Jan. 26 email. The No Surprises Act intends to prevent surprise billing through its IDR process, which is designed to settle payment disputes between…
Republican Gov. Greg Abbott is pressing the Texas HHS Office of the Inspector General and HHS Commission to investigate the state’s Medicaid program for fraud, according to a Jan. 16 letter. The push comes weeks after the federal HHS froze…
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Angle Health Co-founder and CEO Ty Wang thinks recent CMS and FDA initiatives will set a precedent that goes beyond Medicare. The “Advancing Chronic Care with Effective, Scalable Solutions Model” from CMS and “Technology-Enabled Meaningful Patient Outcomes for Digital Health…
CareFirst BlueCross BlueShield is suing CMS over its 2026 Medicare Advantage star ratings, alleging improper calculations cost the insurer an estimated $32 million in quality bonus payments. The lawsuit, filed Jan. 20 in the U.S. District Court for the District…
A handful of states have declared emergency measures ahead of a winter storm slated to begin around Jan. 24. BCBS North Carolina is explicitly allowing early prescription refills, while Tricare — the U.S. Department of Defense’s health insurance program for…
The CEOs of the nation’s largest health insurers drew the ire of lawmakers on both sides of the aisle during congressional hearings that went for more than nine hours Jan. 22 over industry consolidation, prior authorization practices and executive pay,…
The House Judiciary Committee in an interim staff report accuses CVS Health of restricting independent pharmacies from working with digital pharmacy competitors to protect its market position. The report, issued Jan. 21 and titled “When CVS Writes the Rules: How…