Medi-Cal no longer covers GLP-1s for weight loss as of Jan. 1. Wegovy, Zepbound and Saxenda have been removed from the Medi-Cal Rx Contract Drugs List and are no longer eligible for coverage for weight loss or weight-loss indications. The…
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Enhanced ACA premium tax credits expired Dec. 31, with congressional efforts to extend them stalled and no resolution in sight. The enhanced subsidies, introduced under the 2021 American Rescue Plan Act, increased subsidy amounts and expanded marketplace eligibility to households…
Blue Cross and Blue Shield of Alabama is dropping its Medicare fitness benefit, a spokesperson confirmed Dec. 31 to Becker’s. A spokesperson for the insurer said it reevaluates its Medicare benefits “to ensure our products are competitive and remain financially…
Asset limits will return to California’s Medicaid, Medi-Cal, next year, and new enrollments are on pause for those lacking “satisfactory immigration status,” according to the state Department of Health Care Services. While income is the only factor for Medicaid eligibility…
State Medicaid agencies have made an estimated $289 million in improper capitation payments to managed care organizations on behalf of deceased enrollees since 2016, according to a series of audits from the HHS Office of Inspector General. The latest OIG…
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Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Ardent Health, based in Brentwood, Tenn., seeks a vice president of payer strategies. …
Mail-order pharmacies owned by UnitedHealth and Humana dispensed Medicare prescription refills earlier and more frequently than industry peers, according to an analysis of federal prescription data published Dec. 26 by The Wall Street Journal. The analysis found mail-order pharmacies filled…
More than 15.6 million people have enrolled in plans on federally run ACA exchanges so far, down from about 16 million at the same point last year, CMS Administrator Mehmet Oz, MD, said Dec. 23. Dr. Oz attributed the decline…
From releasing a companywide policy audit report to seeking the dismissal of a Medicare Advantage lawsuit filed by Ballad Health, here are 11 updates on UnitedHealth Group and its subsidiaries that Becker’s has reported since Dec. 4: 1. A federal…
A federal judge has granted UnitedHealthcare and PacificSource preliminary injunctions that block Idaho from taking action against the insurers over their Medicare Advantage broker compensation practices. The insurers sued Idaho Insurance Director Dean Cameron in November after the state issued…