Payer

CMS issued a proposed rule Dec. 6 that it says will streamline the prior authorization process. Here are four major changes the rule would bring that would affect payers, according to a Feb. 21 report from the Kaiser Family Foundation:

There's a worldwide shortage of diabetes management drug Ozempic, and health plans may be playing a key role, BuzzFeed News reported Jan. 13.

From its CEO becoming the first woman elected to chair the Business Council, to the payer being named among the nation's best large employers, here are eight updates about Elevance Health Becker's has reported since Jan. 31:

Here are three states seeking or implementing work requirements for their Medicaid programs:

Payers are challenging contract decisions and noncompete agreements in court. 

The number of adults in a Medicaid-enrolled family that are unaware of impending redeterminations remains high across the nation.

A group of 70 lawmakers is pressing CMS on further Medicare Advantage reforms, and the agency is considering implementing prior authorization reforms and other changes to the program. 

The Indiana Department of Insurance tapped data management and analytics firm Onpoint Health to administer the state's All Payer Claims Database. 

Arkansas Gov. Sarah Huckabee Sanders is asking the federal government for a waiver to create work requirements for the state's Medicaid program, CBS affiliate KTHV reported Feb. 15. 

UnitedHealthcare added the most Medicare Advantage members in 2022 among the largest payers. Every payer except Cigna added members in 2022 to their Medicare Advantage plans.