Payer

2023 was an eventful year for Medicare Advantage. 

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. 

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:

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…

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. 

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. 

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.

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 is urging states to do more to prevent eligible children from being disenrolled from Medicaid coverage. 

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.