Payer

Two HIV advocacy groups allege Blue Cross Blue Shield of North Carolina is violating antidiscrimination requirements by pricing HIV drugs in high cost-sharing tiers. 

The No Surprises Act (NSA) had several top stories from 2022 including the recent Department of Health and Human Services (HHS) announcement that enforcement of a key requirement under the act would not start January 1, 2023, as previously scheduled.

Oscar Health will stop accepting new members in Florida through open enrollment on Dec. 13, the company said Dec. 12. 

Payers invested in value-based care throughout 2022, teaming up with Walmart and many other companies to prioritize quality-based payments. 

Changes in payment rates and beneficiary characteristics were the main drivers of the slowdown in Medicare spending growth from 2012 to 2018, a study published Dec. 2 in JAMA Health Forum found. 

From unveiling revenue projections to the delay of its LHC Group acquisition, here are nine stories about UnitedHealth Group that Becker's has reported since Nov. 23. 

Knowing where Medicare Advantage dollars are being spent is a top priority for CMS, Administrator Chiquita Brooks-LaSure said at the Milken Future of Health Summit on Dec. 8. 

Employer-sponsored health costs rose 3.2 percent on average in 2022 and are expected to rise 5.4 percent in 2023, according to a Dec. 8 Mercer survey. 

Sponsors of a bill reforming the Medicare Advantage prior authorization process said the legislation is "one step closer to becoming law" after CMS released a proposed prior authorization improvement rule Dec. 6. 

A judge granted the University of Minnesota a temporary injunction in the university's lawsuit against UCare, preventing the payer from amending its bylaws to change its board while litigation is ongoing.