Payer

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. 

Ten providers recently posted job listings seeking leaders in payer contracting and relations.

A system error caused BlueCross BlueShield of Tennessee to mail 2,688 letters to outdated addresses. 

Medicare Advantage enrollees who use supplemental benefits are more likely to live in areas with fewer resources, according to a report from the Elevance Health Public Policy Institute. 

Nine state Medicaid programs currently cover Wegovy, Novo Nordisk's high-priced weight loss drug, Bloomberg Law reported July 26. 

Aetna, Inland Empire Health Plan and Health Net will expand their reach on Covered California, the state's ACA exchange, in 2023. 

Better data sharing practices can improve value-based care arrangements, according to a new report from AHIP, the American Medical Association and the National Association of Accountable Care Organizations. 

Aetna has been involved in a series of legal challenges and garnered workforce awards in recent weeks. 

Virginia made capitation payments for thousands of Medicaid enrollees after their deaths, an audit from HHS' Office of Inspector General found.