Payer

L.A. Care is working to connect members in temporary care. 

CMS has approved Georgia's plan to transition to a state-based ACA exchange called Georgia Access. 

Humana's board of directors authorized a cash dividend of $0.885 per share to be paid on Oct. 25. 

From UnitedHealthcare announcing a start date for its national gold-card program to a California payer cutting nearly a quarter of its requirements, here are eight updates on prior authorization Becker's has reported since July 11:

The CEOs of the six largest for-profit insurers have different perspectives on Medicare Advantage. 

A swirl of challenges is looming for Medicare recipients ahead of the annual enrollment period beginning Oct. 15.

Elevance Health is launching Mosaic Health, a primary care venture with private equity firm Clayton, Dubilier & Rice. 

In 2023, more than 61% of Ozempic prescriptions went to patients with commercial health insurance, and less than 10% of all semaglutide prescriptions went to Medicaid enrollees, according to a study published Aug. 2 in JAMA Health Forum.

Centene is the most likely to overturn a prior authorization denial decision when appealed, while Humana is the least likely, according to a KFF analysis.

The Medicare Advantage business is facing major challenges — government scrutiny is rising, CMS regulations and payments are tightening, the cost of care is rising and negative media coverage abounds.