Payer

The Ohio attorney general's office has filed a lawsuit against three pharmacy benefit managers, accusing them of sharing pricing and other information gathered by a Swiss subsidiary to gain leverage during negotiations with drugmakers for rebates, The Wall Street Journal…

Nonprofit payer executives are urging CMS to pause its proposed changes to Medicare Advantage to ensure coding updates will not harm dual-eligible MA members. 

AHIP is backing an HHS policy that allows insurers not to count copay coupons toward out-of-pocket maximums. 

Value-based care isn't yet scaling, but price transparency could bring about widespread value-based competition, Trilliant Health CEO Hal Andrews says. 

Kansas lawmakers are considering legislation backed by the Kansas Hospital Association that would reform the prior authorization process.

After a yearslong bureaucratic battle, New York City officials approved an Aetna Medicare Advantage plan for its retired municipal employees, though the plan could be headed for more court battles. 

Two states have now publicly said they are in direct control of Bright Health's financial operations, prompting questions around whether insurance regulators are prepared to protect consumers from startup health plans with uncertain futures.

Kentucky Gov. Andy Beshear has vetoed a bill passed by the state's Legislature that would throw out expanded dental, vision and hearing coverage for 900,000 adults on Medicaid, the Louisville Courier-Journal reported March 24. 

Several payers said it will be impossible to meet Colorado's price targets for its Colorado Option program in 2024, The Colorado Sun reported March 24. 

Two senators are questioning insurers' claims that proposed Medicare Advantage rates would cut member benefits.