Payer

Humana is anticipating its medical loss ratio will be at the top end of its full-year projected range of 86.3 percent to 87.3 percent, according to a June 16 SEC filing. 

The Alliance of Community Health Plans is proposing a set of policies aimed at curbing misleading marketing in Medicare Advantage. 

The nation's retail pharmacy giants are playing an important role in Medicaid redeterminations through payer-agnostic outreach and education initiatives aimed at customers and employees in all 50 states.

More than 1 million people have been disenrolled from Medicaid coverage, according to June 12 data from KFF. 

Cigna is delaying a prior authorization policy and pursuing legal action to keep one of its former executives from joining CVS Health. 

CMS is projecting a 7.7 percent increase in private health insurance spending in 2023, driven by an increase in utilization and rising prices of medical care. 

Four in 5 adults with employer-sponsored insurance rated their coverage positively, but many also reported having problems with their insurance in the past 12 months, according to a survey from KFF. 

From UnitedHealthcare backing off a gastroenterology endoscopy policy, to the American Medical Association raising concerns about the use of artificial intelligence, here are nine updates on prior authorization Becker's has reported since May 11:  

The American Medical Association is raising concerns about the use of artificial intelligence to review claims for prior authorization. 

Just two states — Florida and Montana — have not taken up any temporary waivers from CMS designed to simplify Medicaid renewals.