Payer

Several Blue Cross Blue Shield companies have formed a medication contracting organization, Synergie Medication Collective, aimed at reducing high specialty drug costs. 

A case filed by two former UnitedHealth executives who sued the company for allegedly underpaying them for a billion-dollar business line they helped create has quietly closed, the Minneapolis/St. Paul Business Journal reported Jan. 3. 

Reviewing and approving  prior authorizations has been a necessary but often cumbersome challenge.

Perceived cost is the main barrier to uninsured individuals seeking health coverage on state marketplaces, a survey from Florida Blue found. 

Some methadone treatment providers are concerned Medicare Advantage prior authorization delays are preventing beneficiaries from receiving necessary treatments in time, Roll Call reported Jan. 4. 

Centene boosted its projected earnings per share for 2024 after scoring more Medicaid managed care contracts in California. 

Wells Fargo analysts downgraded Cigna from "overweight" to "equal weight" rating, favoring the payer's competitors, Seeking Alpha reported Jan. 3. 

Ten payers are involved in 85 percent of all disputes involving out-of-network emergency and nonemergency items in services under the No Surprises Act's independent dispute resolution process, according to a recent CMS report. 

Amerigroup Maryland, an Elevance Health subsidiary, has rebranded as Wellpoint Health. 

Medicare Advantage plan Cigna HealthSpring of Tennessee received $5.9 million in overpayments from the federal government in 2016 and 2017, according to an HHS Inspector General's Office audit.