Payer

Novel therapeutics are innovative pharmaceutical and biotech products that improve clinical outcomes, but payers face many challenges when deciding whether to cover them, according to a new report from the Center for Connected Medicine at Pittsburgh-based UPMC and KLAS Research.

Florida has been supervising Bright Health's operations in the state since last fall and plans to continue until at least May 1.

As CMS prepares to implement tougher risk adjustment data validation audits in Medicare Advantage, payers and providers can take steps to boost their compliance efforts. 

Florida lawmakers are looking to limit residents' ability to sue insurance companies in an effort to decrease costs, the Miami Herald reported March 14.

UnitedHealth Group members have asked a federal appeals court to reassess a former ruling in favor of a UnitedHealth subsidiary they say has led to "disastrous consequences" for employee benefit plans and millions of mental health and addiction patients.

With Medicaid redeterminations set to begin April 1, Google is updating its search engine for beneficiaries to find re-enrollment information where they live. 

Blue Cross and Blue Shield of North Carolina is backing bills in the North Carolina Legislature to allow the payer to move some of its assets to a nonprofit holding company, Business North Carolina reported March 13. 

Some of CMS' proposed Medicare Advantage risk adjustment changes will shift resources away from underserved populations, Oak Street Health says.

Humana has completed a $1.25 billion debt offering. 

Payers and providers have expressed concerns about CMS' proposed changes to Medicare Advantage risk adjustments and diagnosis coding.