Payer

Friday Health Plans is shuttering its business nationwide after several states moved to pause new enrollments or regulate the company's finances.

Medicare overpaid millions of dollars for beneficiaries who were in skilled nursing facilities or hospital inpatients, according to an audit from HHS' Office of Inspector General. 

The insurance segment of Highmark Health reported $130 million in operating income for the first three months of the year, according to a company earnings report posted May 31.

Democratic lawmakers in California are frustrated with Gov. Gavin Newsom over how he plans to use funding that originates from fines against those without health coverage, the Los Angeles Times reported May 31.

A group of retired New York City employees are suing Mayor Eric Adams and other city officials in an attempt to block the city's planned switch to an Aetna Medicare Advantage plan for the 250,000 retired city workers and dependents…

Medicare beneficiaries pay more on average than commercial beneficiaries for "ultra-expensive" drugs, a study published in JAMA Health Forum found. 

Optum Rx is launching a new initiative aimed at using pharmacies to bridge healthcare gaps in rural and underserved communities. 

Member satisfaction in commercial health plans declined from 2022 to 2023, especially among younger generations, according to J.D. Power's 2023 Commercial Member Health Plan study. 

Customer satisfaction in health plans is declining, according to J.D. Power's 2023 Commercial Member Health Plan study. 

Florida officials are defending their Medicaid redetermination process after health advocacy groups asked Gov. Ron DeSantis for a pause after about 250,000 residents were disenrolled from the program, Florida Politics reported May 24.