Payer

California regulators raised concerns about hiring practices and a surplus of funds at CalOptima Health, a managed care plan with nearly 1 million members. 

Payers are anticipating the cost of expensive new gene therapy drugs to be a significant issue in the coming years, according to a survey from the Pharmaceutical Strategy Group. 

Twenty-six state attorneys general are asking Medicare to cover monoclonal antibody treatments for Alzheimer's disease. 

Georgia Gov. Brian Kemp signed legislation May 2 that establishes a state-managed ACA exchange, pending approval from CMS.

A Montana judge is temporarily halting a rule that would require prior authorizations for Medicaid-paid abortions, the Daily Montanan reported May 1. 

Arbitrators sided with physician services company Envision Healthcare in its dispute with UnitedHealthcare over allegations the payer breached their contract by reducing reimbursement rates. 

Bright Health is moving to sell the last of its Medicare Advantage business, and new enrollments are boosting payers' first-quarter earnings. 

I have held titles throughout my life and career that reinforce my commitment to healthcare and caring. I’m the chief medical officer at Blue Cross Blue Shield of Arizona, former director of the Arizona Department of Health Services, and above…

Medicare Advantage enrollment has surpassed traditional Medicare for the first time in the program's history.

Clover Health CFO Scott Leffler was paid $13.5 million in total compensation in 2022, according to regulatory filings published April 26.