Payer

Nineteen senators co-signed a letter to HHS and CMS urging the agencies to cover at-home COVID-19 tests for Medicare beneficiaries. 

Although the price transparency elements of the No Surprises Act do shake up the payer-provider dynamic, the true controversy surrounding the act involves out-of-network rate mediation, Larry Levitt, Kaiser Family Foundation executive vice president for health policy, wrote in a…

Health New England is expanding federally mandated coverage of at-home COVID-19 tests to include its Medicare Advantage members. 

Health insurers are covering between 61 percent and 74 percent of the costs of ivermectin, a treatment for parasites in humans and animals, despite guidance from the FDA that it should not be used to treat COVID-19.

The state of Georgia is suing HHS after the agency implemented changes that removed a requirement for Medicaid beneficiaries to work in order to be eligible for coverage, Bloomberg reported Jan. 21. 

Anthem Blue Cross Blue Shield named Robert Bunch president Jan. 20, but the move comes as the payer potentially faces a new opponent in its legal battle against Atlanta-based Northside Hospital System, according to 11Alive. 

The coverage gaps created by the Biden administration's at-home COVID-19 test coverage guidelines doesn't solve barriers for a population that faces already-increased risks: Medicare beneficiaries, according to a Jan. 24 Kaiser Health News report. 

HHS' Office of the National Coordinator for Health Information Technology is looking for public comments on prior authorization to help guide standards, implementation and certification. 

GS Labs is responding to a July 2021 lawsuit from Blue Cross and Blue Shield of Kansas City with a counterclaim that alleges the payer violated federal antitrust laws and conspired with other affiliated companies to withhold payments. 

Oscar Health is providing members with an enhanced virtual cost estimation tool in an effort to increase medical cost transparency.