Payer

From an appellate court blocking an attempt to prevent Horizon Blue Cross Blue Shield's reorganization, to arbitrators ruling that UnitedHealthcare must pay Envision Healthcare $91 million in a billing dispute, here are eight lawsuits and settlements involving payers Becker's has…

The 69th Fortune 500 was released June 5. Five payers were included in the top 25 on the annual list of the largest corporations in the U.S. ranked by revenue for the 2022 fiscal year. 

A court blocked a challenge from a nonprofit and a nurses union seeking to prevent Horizon Blue Cross Blue Shield from reorganizing as a nonprofit mutual holding company, nj.com reported June 1. 

Medicaid continuous coverage requirements are unwinding, and in many states, individuals have lost coverage due to procedural reasons. 

Emily Zalkovsky has been named Texas Medicaid director, effective July 1. 

Friday Health Plans is the fourth payer to exit Colorado's insurance market in the past year. 

Ford Motor Co. is suing BCBS Michigan, along with the BCBS Association, over an alleged antitrust conspiracy among Blues plans to fix healthcare prices, thereby overcharging Ford for health insurance provided to its employees.

UnitedHealthcare pulled back on plans to implement a controversial gastroenterology endoscopy prior authorization policy that was set to take effect June 1. In its place, the payer set up an advance notification policy for non-screening and nonemergent GI procedures.   

Medicaid redeterminations are underway, and many experts say the process is going worse than expected. 

A New York City plan to implement Medicare Advantage for retirees is being challenged in court again, and federal lawmakers are pressing the largest Medicare Advantage insurers on claims denials.