Payer

From Molina failing to quickly pay providers to Centene settling with an 11th state over allegations it overbilled Medicaid programs, these are six recent fines levied against payers by states: 

A video of a woman vomiting in the parking lot of an Anthem Blue Cross Blue Shield office in Los Angeles has gone viral across social media after the payer denied her coverage of treatment for a stomach condition.

Philadelphia-based managed care organization Health Partners Plans is partnering with Fabric Health for outreach at five laundromats in the city, Philadelphia Business Journal reported Aug. 29. 

Medicare Advantage plans are expected to make up half of all Medicare enrollment by 2026, with the national average currently at 45.5 percent. Some states, however, are lagging behind the rest of the country. 

Bright Health Group has told Florida regulators there is "substantial doubt" the company can remain financially viable without additional outside investment, the Star Tribune reported Aug. 25.

From its CFO being added to a class-action lawsuit, to acquiring a Medicare health insurer in Houston, here are six headlines about UnitedHealth Group since Aug. 1: 

Cigna will offer health plans on the individual ACA marketplace in three new states and will expand its offerings in three other states for the 2023 coverage year.

Despite the gradual move away from fee-for-service payment models, value-based contracts are still only a small percentage of overall medical revenues, according to an August report from the Medical Group Management Association.

CMS is investing $98.9 million in organizations that help people navigate the ACA marketplace, Medicaid and Children’s Health Insurance Program enrollment during the 2023 open enrollment period. 

UnitedHealthcare and Humana account for 46 percent of the 28.4 million people enrolled in Medicare Advantage plans in 2022, according to the Kaiser Family Foundation.