Payer

Around 20 percent of Medicare enrollees are also enrolled in Medicaid benefits, according to a report from Kaiser Family Foundation published Jan. 31. 

Kaiser Permanente will refund 7,600 members in Colorado after a software update incorrectly calculated how much members had paid toward their deductibles, the Denver Post reported Feb. 3. 

Humana is appointing new executives and expanding CenterWell, its primary care business. 

CMS is lacking data on how Medicare Advantage supplemental benefits are used, according to a report from the U.S. Government Accountability Office. 

A law that went into full effect in 2019 granted Oregon residents free reproductive healthcare coverage, but state officials found that at least 12 insurers continued to charge beneficiaries, according to a Feb. 1 report from the Oregon Capital Chronicle.  

Cigna beat investor expectations and reported $1.2 billion in profit for the fourth quarter, according to its year-end earnings report published Feb. 3.

More scrutiny is expected for providers who serve patients covered by Medicare Advantage.

Elevance Health has the highest number of prior authorization requests per Medicare Advantage member, while CVS and Kaiser Permanente have the highest rate of denials in 2021, according to an analysis from Kaiser Family Foundation. 

Medicare Advantage plans fully or partially denied around 6 percent of prior authorization claims in 2021, according to an analysis from Kaiser Family Foundation published Feb. 2. 

From CMS issuing a proposed rule to streamline the process, to a report indicating a majority of states could introduce bills this year to limit or change the process, here are nine stories about prior authorization Becker's has reported since…