Payer

The council of the District of Columbia voted to approve awarding Medicaid contracts to Amerigroup, MedStar Family Choice and AmeriHealth Caritas D.C., despite protests from CareFirst Blue Cross Blue Shield, The Washington Post reported Oct. 18. 

Payer-negotiated prices for radiology services can vary widely, even within the same hospital, a study published Oct. 18 in Radiology found. 

Elevance Health took in $1.6 billion in net income for the third quarter and raised its earnings outlook for the rest of the year, according to the company's earnings report published Oct. 19.

Enrollees in ACA marketplace plans hit record highs in 2022, a Kaiser Family Foundation analysis published Oct. 17 found. 

UnitedHealth Group has expanded its behavioral health network by 25 percent "over the last couple of years," according to president and COO Dirk McMahon.

Illinois insurance regulators are fining Centene subsidiary Celtic Insurance Co. $1.25 million for allegedly failing to cover mental health and addiction services at the same level as other medical issues, the Chicago Tribune reported Oct. 18. 

Forty percent of those who chose traditional Medicare over Medicare Advantage did so because of greater provider choices, according to a survey released Oct. 17 by the Commonwealth Fund. 

The American Arbitration Association, the largest provider of arbitration and mediation services, has updated its rules for mediating payer-provider disputes, the association said Oct.18. 

Most city- and state-level commercial prescription drug markets are highly concentrated, with one pharmacy benefit manager controlling a large share of the market, a report published Oct. 13 by the American Medical Association found. 

CMS is considering adding more qualifying conditions for Medicare-covered dental treatment, Kaiser Health News reported Oct. 17.