Payer

Humana is challenging a CMS rule that would implement stricter auditing standards on Medicare Advantage plans. 

UnitedHealthcare says it did not breach its contract with Greenville, S.C.-based Prisma Health, and said the health system "coordinated a media effort to put pressure" on the insurance giant. 

Centene has moved to divest its overseas businesses and lost out on contract decisions in recent weeks. 

GoodRx has launched a new feature that allows providers to check a patient's insurance benefits when prescribing medications to better understand the final cost.

Wegovy, Novo Nordisk's expensive weight loss drug, could reduce the risk of cardiovascular events — but at a steep cost to insurers, Bloomberg reported Aug. 31. 

Health plans have historically struggled to deliver personalization that increases member engagement, improves care coordination, drives better outcomes and reduces costs. That’s despite spending 10% or more of their administrative budget on care management, according to McKinsey & Company, which…

More than 5 million people have been disenrolled during the Medicaid redeterminations process. In some states, Medicaid recipients have filed legal challenges to the process, and whistleblowers are raising alarms. 

Wellcare, Centene's Medicare Advantage business, is partnering with the American Legion on Medicare Advantage plans designed to complement benefits veterans receive through the VA. 

CenterWell, Humana's older-adult focused primary care business, is expanding to in-home primary care. 

Greenville, S.C.-based Prisma Health is alleging UnitedHealthcare breached its confidentiality agreement with the system in the midst of contract negotiations.