Payer

In the first five weeks of open enrollment, 1.2 million people have signed up for ACA exchange plans for the first time, and 4.3 million have renewed their plans or selected new options on the marketplace, HHS said Dec. 7. 

New York Gov. Kathy Hochul announced a new regulation aimed at protecting consumers from "unfair, surprise costs" when they rely on incorrect information in an insurer's healthcare provider directory. 

Using electronic processes is by far the most common way commercial health insurers said they streamline prior authorizations, according to a Nov. 14 America's Health Insurance Plans survey. 

Blue Shield of California is expanding its collaboration with home health provider DispatchHealth. 

Startup health plan Enthea has raised $2 million in seed funding and is preparing to launch the nation's first employee benefit for psychedelic-assisted therapy in dozens of markets next year.

Eleven states will provide government health benefits to children without permanent legal status in 2023, Stateline reported Dec. 6. 

At the first Becker’s Payer Issues Roundtable event on November 7-8, a leadership panel discussed payers’ top priorities.

CMS' Dec. 6 proposal to improve the prior authorization process was met positively from groups ranging from America's Health Insurance Plans to the Medical Group Management Association. 

Payment fraud can seem like an existential threat to payers. The reality is that healthcare payments are a constant target for payment fraud, and payers drive many of the transactions that are the most valuable to fraudsters, including claim payments…

CMS issued a proposed rule that it says will streamline the prior authorization process and estimates the efficiencies introduced in the proposal would save hospitals and physician practices more than $15 billion over a 10-year period.