Payer

A New York judge ruled that New York City cannot penalize retirees who decline to participate in a controversial new retiree Medicare Advantage plan provided by Emblem Health and Anthem subsidiary Empire Blue Cross Blue Shield, according to the New…

The National Association of Accountable Care Organizations is forming a new coalition to educate providers on CMS' new ACO REACH model. 

From accusations that Clover Health misled investors to UnitedHealthcare dodging an attempt to reveal negotiated rates with contracted providers, here are five recent legal actions involving payers:

A bill introduced in Congress would require the government to warn adults 60 and older of penalties associated with late Medicare enrollment, according to a March 2 CNBC report. 

A judge denied a motion to dismiss a lawsuit out of Nashville, Tenn., that accused Clover Health of misleading investors, according to a Feb. 28 court order. 

Building a provider network is challenging. Government regulations are changing, competitors are fast moving, and info sources are scattered. Further, the right network is defined differently by each organization depending on goals and initiatives, member population and more.

David Jones, Humana's cofounder, is being memorialized in the company's home city of Louisville, Ky., by a statue created by locally admired artist Ed Hamilton, according to ABC affiliate WHAS11. 

As Excellus BlueCross BlueShield reported year-over-year profit growth, the payer also recorded some of its largest medical expense payouts in more than 20 years, according to the Democrat & Chronicle. 

Employers are continuing to put retirees on Medicare Advantage health plans in an effort to save money, but many are doing so at the cost of disrupting care, according to a March 2 Fortune report. 

While only a handful of payers dominate the health insurance market nationally, the cast diversifies when broken down by the largest payer in each state.