Payer

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. 

Mark Cuban's online pharmacy, Cost Plus Drug Co., has picked up another partner to help it enter the specialty drug market.

Cigna is being sued by the Justice Department for allegedly making its Medicare Advantage members appear sicker than they were by submitting false diagnosis codes to the government in order to receive higher reimbursement rates.

Apple will reportedly enter the health insurance business in 2024 in partnership with a major payer, Forbes reported Oct. 18.

Despite little growth in the cost of medical services over the last year, inflation has finally caught up with healthcare.

California's first-ever Medicaid managed contract procurements are a major shakeup in the state's Medi-Cal system, which has over 12 million enrollees, or a third of California's population. 

Medically tailored meals could result in large cost savings for payers, a study published Oct. 17 in JAMA Network Open found.