Payer

A $5,000 out-of-pocket spending cap on Medicare would result in major savings for enrollees, but would also increase federal Medicare spending by $38.8 billion in 2023, according to a study published June 6 by the Urban Institute.

The U.S. District Court for the District of New Jersey is allowing a lawsuit to proceed against Cigna that alleges the payer has illegally refused to reimburse a radiology lab for $1.5 million spent on COVID-19 testing, violating the Employee…

Federal funding rules will limit Medicaid's ability to provide abortion access if Roe v. Wade is overturned, CNBC reported June 8. 

Medicare spent an average of $14,173 per beneficiary in 2019, according to a June 7 report from the Kaiser Family Foundation. 

Much of the world has changed because of the COVID-19 pandemic, and that includes the emergence of virtual-first health plans, or insurance policies that prioritize telehealth for enrolled members.

Ten consumers told Kaiser Health News they thought they were signing up for health insurance plans through the ACA marketplace, but instead ended up with a membership in a Houston-based healthcare-sharing ministry, the outlet reported June 7. 

The Federal Trade Commission is launching an inquiry into the pharmacy benefit manager industry and requiring the six largest PBMs to provide information and records regarding their business practices. 

Anthem is launching a new telehealth platform to offer digital care to women for pregnancy, menopause and other women's health issues through a partnership with New York City-based Happify Health.

Over 3 million people will lose health coverage and marketplace enrollees will face significantly higher premiums if Congress does not extend the premium tax credits in the American Rescue Plan Act, according to the Urban Institute.

Health savings accounts alongside qualifying high-deductible health plans may have outlived their usefulness, according to an analysis published this month in Health Affairs.