Payer

A nonprofit and a nurses union filed a lawsuit seeking to block Horizon Blue Cross Blue Shield's reorganization into a nonprofit mutual holding company, the New Jersey Monitor reported Dec. 14.

Oscar Health has gone through several transitions in recent months, with shake-ups in its executive suite and exits from two state markets. 

The drug-pricing provisions of the Inflation Reduction Act only apply directly to Medicare, but the new policies will have effects across the entire market, according to an analysis published Dec. 14 in Health Affairs. . 

The number of uninsured children in the U.S. dropped from 4,375,000 in 2019 to 4,165,000 in 2021, according to a Dec. 7 report from Washington, D.C.-based Georgetown University Health Policy Institute's Center for Children and Families. 

The Blue Cross Blue Shield Association is adding new health-equity focused standards to its Blue Distinction Centers for Maternity Care designations. 

A group of payers will display CMS' new "birthing-friendly" hospital designation in their provider directories. 

The California Department of Health Care Services is transitioning 325,000 dual-eligible beneficiaries to Medi-Cal managed care Jan. 1, according to the California Medical Association. 

From UnitedHealth Group defeating the Justice Department's challenge of its Change Healthcare acquisition to the approval of a $2.67 billion Blue Cross Blue Shield antitrust settlement, here are 10 key court cases involving payers that Becker's reported in 2022:

Payers added partnerships with top tech companies, fitness brands and billionaire entrepreneur Mark Cuban's new pharmacy in 2022. 

Around 5 percent of Medicare Advantage plans are audited each year, Kaiser Health News reported Dec. 13.