Payer

Most private payers do not cover new drugs meant to treat obesity, but Medicaid programs in a few states do, Bloomberg reported April 27. 

Georgia is paying hackers to break into Georgia Gateway — the system residents access for programs like Medicaid — to search for vulnerabilities, The Atlanta Journal-Constitution and Axios reported April 27. 

Legislation that would allow Blue Cross and Blue Shield of North Carolina to reorganize, adding a nonprofit parent holding company, is moving ahead in the state's House of Representatives. 

Elevance Health CEO Gail Boudreaux was paid 383 times more than the company's median employee in 2022. 

Insurer groups say hospitals are to blame for higher costs of specialty drugs, while hospitals say the problem stems from drug manufacturers and pharmaceutical benefit managers. 

Ensuring adequate coverage across provider networks is a top priority for health plans that want to stay competitive and offer a positive member experience. But for patients to benefit from plan coverage, they first need access to accurate and transparent…

Centene posted $1.1 billion in profit in the first quarter of 2023 in its earnings report filed April 25. 

Pharmaceutical benefit managers are often choosing higher-priced options as biosimilar competitors to Humira hit the market, Bloomberg reported April 26. 

Humana posted a 33 percent increase in profits year over year and added more than 500,000 Medicare Advantage members in the past year, according to its first-quarter earnings posted April 26. 

The North Carolina Department of Insurance is suspending new enrollment in Friday Health Plans.