Payer

Some Medicare Advantage plans are not planning to comply with new CMS guidance requiring plans to follow traditional Medicare's standards for coverage decisions, the American Hospital Association alleges. 

CMS paid Medicare Advantage organizations an estimated $16.6 billion in overpayments in fiscal year 2023, the agency reported Nov. 15. 

Four in 10 employers offer low or no-deductible plans, and 15% of employers will offer their employees coverage with no premium, according to Mercer's "Health and Benefit Strategies for 2024" report. 

From UnitedHealth expanding plans to 26 states total to Centene expanding its footprint within 11 markets, these are six payers expanding their exchange offerings in 2024.

Half of states are "failing" amid the Medicaid redeterminations process, according to the NAACP. 

Three payer CEOs are among As You Sow's list of the most "overpaid" CEOs at S&P 500 companies. 

Excellus BlueCross BlueShield awarded 31 upstate New York hospitals and health centers a combined $28 million in 2022 for quality care improvements.  

CMS issued its first-ever playbook to address social determinants of health Nov. 16. 

Georgia Republican lawmakers heard testimony on possible Medicaid expansion for the first time in a decade, The Atlanta Journal-Constitution reported Nov. 17. 

Fewer Medicare Advantage beneficiaries are choosing no-premium plans for 2024, according  to eHealth's November snapshot report that tracks MA and Part D plans selected by beneficiaries in the first half of the current annual enrollment period, or Oct. 15 to…