Payer

Hundreds of physicians across the nation have taken to Twitter to share their thoughts on a simple question: What is the insurance denial in your specialty that frustrates you and your patients the most?

House Republicans have included Medicaid work requirement proposals in their bill to raise the debt ceiling into next year, The Washington Post reported April 20. 

Hospitals across New Hampshire say Anthem's operations and overall performance in the state has left providers with $300 million in unprocessed claims and created "universal dissatisfaction" with the Elevance Health subsidiary. 

Elevance Health is planning to expand its post-acute care management program, a move the company's leaders say will contribute to the payer's growth in 2023. 

Express Scripts, a pharmaceutical benefit manager owned by the Cigna Group, is increasing reimbursement rates for some independent pharmacies in rural areas. 

From posting double-digit growth in the first quarter of 2023 to acquiring a New York.-based multispecialty physician group, here are eight headlines about Optum that Becker's has reported since March 22. 

Pharmaceutical Research and Manufacturers of America says CMS' guidance for Medicare drug price negotiation disadvantages manufacturers and will hurt innovation. 

Elevance Health, formerly known as Anthem, does not cover GLP-1 drugs prescribed only for weight loss, except in states that require coverage of the drugs by law. 

Independence Blue Cross and Philadelphia-based Penn Medicine are piloting a program that will allow qualifying physicians to skip prior authorization approvals needed for ultrasounds, CT scans and PET scans, The Philadelphia Inquirer reported April 18. 

Medicare Advantage enrollees across racial and ethnic groups have similar responses to self-reported patient experience measures, but disparities persist in clinical outcomes.