Payer

Diabetic patients that were forced to enroll in a high-deductible health plan by their employer faced a higher risk of acute diabetes complications compared to those enrolled in traditional health plans, according to a study published Jan. 20 in JAMA…

It's now been over six months since consumers gained access to healthcare pricing information through their health plans — but some experts say the published data is largely unusable or doesn't steer patients in the right direction for care.

Winchester, Va.-based Valley Health has joined as an owner of Peak Health, a health plan launched by Morgantown-based West Virginia University Medicine. 

Payers are implementing new programs to curb spending on prescription drugs, particularly specialty drugs. These medicines, prescribed to a small number of patients, accounted for half of prescription drugs costs in 2021, per HHS.

Danville, Pa.-based Geisinger Health Plan has been fined $125,000 for wrongly rejecting health insurance claims, PennLive reported Jan. 27. 

Cigna is suing former executive Amy Bricker and CVS, alleging her departure to the rival violated a noncompete agreement, according to a federal lawsuit filed Jan. 26. 

As many as 42 states could introduce bills this year to limit or change prior authorization, Miranda Motter, AHIP's vice president of state affairs, told Axios Jan. 27. 

Ten providers — including Cone Health and Orlando Health — recently posted job listings seeking leaders in payer contracting and relations.

Independence Blue Cross is launching a network to manage the cost and outcomes of gene-based therapies with Philadelphia-based Penn Medicine and Children's Hospital of Philadelphia. 

Angle Health, a health insurer that launched in 2021, has raised $58 million in series A funding.