Payer

Florida has removed some children with complex medical needs from Medicaid through the redeterminations process, some advocates and families say, according to a June 28 Orlando Sentinel report. 

Three states named new Medicaid directors in June: 

A former Highmark Health employee is facing criminal charges for allegedly attempting to or withdrawing nearly $90,000 from eight member's health savings accounts, the Pittsburgh Tribune-Review reported June 26.

Humana said it will wind down its commercial group insurance over the next 18 to 24 months, and it shuttered its SeniorCare clinics in the first half of 2023. 

Colorado will ensure providers are paid for Friday Health Plans' members' care, the state's department of insurance said. 

Medicare Advantage enrollees with more chronic conditions are not more likely to switch to fee-for-service Medicare, a study published June 26 in JAMA found. 

UnitedHealthcare executives recently warned of rising healthcare utilization rates as they saw a higher-than-expected number of hip replacements, knee surgeries and other elective procedures. Analysts from UBS Group AG are suggesting that pickleball could be one factor driving the higher…

The majority of health plans surveyed in a report by the Pharmaceutical Strategies Group said they are "very concerned" about off-label use of medications for weight loss. 

The Cigna Group went through a rebranding and beat investor expectations in the first half of 2023. 

Colorado has canceled a set of hearings meant to probe payers and hospitals over rates, after payers met the state's public option price targets.