Payer

Here are 10 recent legal actions involving payers:

California state officials ordered Golden State Medicare Health Plan to break all existing contracts with clients by June 1, with Medicare coverage ending August 1, according to the San Luis Obispo Tribune.

CMS Administrator Chiquita Brooks-LaSure said "time is of the essence" for Congress to extend ACA subsidies, MarketWatch reported June 22.

The Association for Community Affiliated Plans, a trade group of 74 nonprofit health plans representing over 20 million members, is urging federal lawmakers to increase support for addressing social determinants of health through proposed health equity policies.

First announced in 2016, the joint-venture health plan between Banner Health in Phoenix and Aetna has hit several milestones: five years of operations and more than 375,000 enrollees.

Optum has launched a comprehensive laboratory benefit management solution aimed at helping payers reduce unnecessary lab testing and ensuring that members can receive high-quality tests most appropriate for them.

On June 21, the U.S. Supreme Court declined to hear UnitedHealthcare's appeal of a CMS rule meant to recoup Medicare Advantage overpayments from payers.

The Justice Department said Molina Healthcare and former subsidiary Pathways of Massachusetts have agreed to pay a settlement of $4.625 million over allegations of False Claims Act violations and improper licensure and supervision of healthcare employees.

COVID-19 was the eighth-highest condition for stop-loss claims reimbursement, and there was a 354 percent increase in the total number of claims compared to 2020, according to a report published June 21 by Sun Life.

New Jersey state officials are no longer looking to claw back $34 million from Horizon Blue Cross Blue Shield of New Jersey for a service that allegedly was not provided to state employees through their health plan, Bloomberg reported June…