Payer

Many state Medicaid offices have declined to pay for remote patient monitoring programs despite being touted by successive White House administrations as a way to improve health and reduce unnecessary government spending, Politico reported Oct. 26.  

With average Medicare Advantage star ratings seeing a decline nationwide, payers like Centene are facing lower revenues in 2024 after missing out on federal bonuses tied to the quality ratings. 

UnitedHealth Group's OptumRx arm is denying it agreed to pay $15 million to settle overcharging allegations, the Ohio Capital Journal reported Oct. 27. 

Average premiums for employer-sponsored health insurance stayed largely stable this year, but that could change soon, according to the annual Employer Health Benefit Survey from Kaiser Family Foundation. 

A Pennsylvania bill aiming to streamline the prior authorization process is headed to the governor's desk after state lawmakers passed the legislation Oct. 26. 

Molina Healthcare reported a 61 percent increase in net income in the third quarter of 2022 compared to the same quarter in 2021, according to the company's Oct. 26 earnings report. 

UnitedHealthcare will continue to offer free Apple Fitness+ subscriptions to members with employer-funded health plans.

Aetna Better Health of Virginia and managed care startup Waymark have partnered to provide community-based care services to Medicaid members.

Ahead of the beginning of open enrollment on the ACA marketplace, the Biden administration is touting 2023 as the most "competitive marketplace in history" for exchange plans. 

Colorado Insurance Commissioner Michael Conway says the state's Colorado Option — a state-sponsored plan requiring payers to sell plans at lower prices — was successful. Insurers say it hasn't reduced prices, the Colorado Sun reported Oct. 26.