Payer

Medicare Advantage plans designed for dual eligible populations are not broadly outperforming plans not specifically catered to this population, a new study in Health Affairs found. 

From rulings that could strike down preventive care requirements, to Medicaid fraud settlements, here are seven recent legal updates involving payers Becker's has reported on since Sept. 1. 

The dispute between CareFirst BlueCross BlueShield and Johns Hopkins Health System is the result of structural issues within the state's unique health insurance system, Maryland State Medical Society President Gene Ransom said.

Cityblock Health, a New York City-based startup focused on providing care to low-income patients, is expanding to Indiana through a partnership with MDwise. 

The American Hospital Association said some Medicare Advantage policies can hurt beneficiaries, contribute to clinician burn and drive up the cost of care. 

The National Committee for Quality Assurance has named the top-performing health plans of 2022 based on factors that include care quality, patient satisfaction and efforts to keep improving.

The National Committee for Quality Assurance has named the top-performing health plans of 2022 based on factors that include care quality, patient satisfaction and efforts to keep improving.

Centene will pay Texas $165.6 million to settle the state's investigation into if the payer violated Medicaid fraud laws, the Texas Attorney General's Office said Sept. 19. 

Only one of the eight payers operating in Colorado's new state-sponsored plan will meet state benchmarks to reduce premiums by 5 percent this year, according to a report from the Colorado Consumer Health Initiative. 

Medicare Advantage and traditional Medicare plans have similar rates of satisfaction with care and overall care coordination among beneficiaries, a review, published Sept. 16, of 62 studies comparing the plans found.