Payer

Many local commercial and exchange markets are largely controlled by one payer, according to the American Medical Association. 

Medicare Advantage plans have faced scrutiny for possible upcoding and pressure to update provider directories. Here are nine Medicare Advantage updates Becker's has reported since. Nov. 18. 

From adding Humira biosimilars to its pharmacy formulary to Evernorth becoming a minority owner in VillageMD, here are nine stories about Cigna that Becker's has reported since Nov. 9: 

The owner of San Antonio-based Superior Home Health Services has been indicted in connection with the theft of employee insurance premiums, ABC-affiliate KSAT reported Dec. 2.

The sponsor of the Senate's version of a bill to reform the Medicare Advantage prior authorization process called prior authorization the "No. 1 physician and administrative concern in America."

Updated estimates from the Urban Institute and Robert Wood Johnson Foundation show that 18 million people could lose Medicaid coverage when the COVID-19 public health emergency ends. 

The HHS' Inspector General's Office released audits of nine Medicare Advantage plans over the last six months, according to the organization's semiannual report to Congress, published Dec. 5. 

Alabama Medicaid reached an agreement with the Justice Department to end a longstanding policy that denied coverage of hepatitis C medication for those who consumed alcohol or drugs within six months of starting treatment or while using the medication.  

Centene's philanthropic arm and the company's Texas subsidiary, Superior HealthPlan, donated $7.9 million to a new community center in Uvalde, Texas. 

Payers continue to rapidly expand their mental and behavioral care provider networks nationwide in an effort to meet the rising demand from members.