Payer

Medicaid redeterminations have thrown state agencies and millions of vulnerable people into chaos nationwide, a situation being described as an "emerging disaster," according to a July 27 column in the Los Angeles Times by Michael Hiltzik, a Pulitzer prize-winning reporter…

Molina Healthcare reported $309 million in net income in the second quarter of 2023, up 24.6 percent from the same time period last year, according to the company's earnings report published July 26. 

Several states have expanded Medicaid or other state-funded coverage options to noncitizens, according to an analysis from KFF published July 26. 

Cigna Healthcare is pushing back on reporting from ProPublica and a lawsuit in California that accuse the payer of denying large batches of members' claims without individual review, thereby denying them coverage for certain services.

UnitedHealthcare controls almost one quarter of the Medicare Part D plan market, according to an analysis from KFF. 

Blue Shield of California and Microsoft are partnering on a cloud ecosystem that will integrate disparate sources of member data in a consolidated, near-real-time format.

Morgan Stanley analysts predict the weight loss drug market will hit $77 billion by 2030, MarketScreener reported July 21.

Most states oversee payers' requests for higher premium rates from members, and some states have additional oversight requirements, including oversight around the financial impact of payer-provider contract negotiations, according to a July 21 analysis from the National Conference of State…

A group of lawmakers is urging the Biden administration and Congress to do more to limit Medicare Advantage overpayments, misleading marketing and prior authorization denials. 

A bill aiming to reform the Medicare Advantage prior authorization process was included in a package of healthcare legislation that passed the House Ways and Means Committee and is headed to the full House for further consideration.