Payer Archives - Page 399 of 1145 - Becker's Payer Issues

Payers are seeing major Medicare Advantage enrollment, and they want to grow more

Medicare Advantage enrollment saw major growth across the insurance industry in the first quarter of 2022 and over the last year. Now, payers are making plans to increase that growth even further.

Friday Health Plans pulls in $120M to grow ACA enrollment

Friday Health Plans Management Services Co., a Denver-based health insurance holding company, has raised $120 million in funding to primarily offer its health plans in new Affordable Care Act marketplaces.

Settlement OK'd in Anthem Blue Cross eating disorder class-action

A federal judge in California has approved a class-action settlement requiring Anthem Blue Cross to reprocess claims for eating disorder treatments or pay up to $5,500 for denied claims, Bloomberg reported May 25.

Federal bill proposes FTC regulation of PBMs

Bipartisan legislation was introduced May 24 in the Senate that would allow the Federal Trade Commission to increase drug pricing transparency and suppress pharmacy benefit manager practices such as spread pricing and payment clawbacks.

American Medical Association: Payers are failing at prior authorization reform

The American Medical Association criticized the health insurance industry May 24 for what it says are slow or ineffective prior authorization reforms implemented over the last four years, despite payers agreeing to changes aimed at improving care access and efficiency.

Centene in the headlines: 8 recent stories

From earning a spot on the Fortune 500 to signing definitive agreements to sell Magellan Rx and Pantherx Rare, here are eight headlines about the St. Louis-based payer:

Viewpoint: The new dominance of Medicare Advantage is likely to change healthcare as we know it

Medicare Advantage is likely to be the dominant source of Medicare coverage by 2025. This recent development will force payers and providers to find new ways to set Medicare Advantage reimbursement rates and will reimagine the role that traditional fee-for-service…

Payer