Payer

A federal judge in Washington state has granted a class action against Blue Cross Blue Shield of Illinois that accuses the payer of denying gender-affirming care coverage under a self-funded health plan, thereby violating the anti-discrimination provision of the ACA.

Centene delivered "unacceptable" performance for its Medicaid managed care contract for Illinois foster youth, an investigation from the Illinois Answers Project published in the Chicago Sun-Times found. 

Aetna is partnering with Crossover Health to bring in-person and virtual value-based primary care to employer-sponsored health plans in the Seattle area. 

Several payers are among the more than 100 healthcare organizations signing on to the White House and HHS' Health Sector Climate Pledge. 

The nation's largest payers each expanded their Medicare Advantage offerings into hundreds more counties in 2023, according to a Nov. 10 report from the Kaiser Family Foundation.

South Dakota voters approved a measure to expand the state's Medicaid program under the ACA, but a slow rollout could occur, a Georgetown professor told Kaiser Health News Nov. 10. 

Clover Health CEO Andrew Toy told investors Nov. 7 that the company is reducing its participation in CMS' ACO Reach model by two-thirds.

UnitedHealth Group's acquisition of home-health firm LHC Group is reportedly on track to be completed by December. The deal is one of several large mergers and acquisitions conducted by the company this year.

CenterWell, Humana's primary care organization, will open three primary care clinics for older adults in Louisville, Ky., as it continues to expand its footprint. 

CareFirst BlueCross BlueShield has named Matthew Snyder, former senior vice president of internal audit, compliance and risk management at Centene, as its first chief risk officer.