Payer

Payers maintain one of the few remaining ways of holding accountable the 15 percent of U.S. adults unvaccinated against COVID-19: leveraging insurance surcharges and discounts, columnist Glenn Altschuler wrote in a Jan. 10 column for The Hill. 

New Hampshire's Justice Department announced a $21 million settlement with Centene and two of its subsidiaries — Granite State Health Plan and NH Healthy Families — over the payer's pharmacy benefit services.

New Hampshire Anthem Blue Cross and Blue Shield President Lisa Guertin is retiring from her position in March after 18 years at the helm, according to NH Business Review.

A California court ruled against United Behavioral Health, a UnitedHealth Group subsidiary, ending a multiyear class-action lawsuit and requiring the provider pay out over $20 million, according to Bloomberg. 

While conversations around partisanship, funding and education surround President Joe Biden's Build Back Better Act, spectators are largely ignoring how close the bill brings the U.S. to reaching universal healthcare, Washington Post columnist Katherine Rampell wrote Jan. 6. 

South Dakota voters will have a voice in whether the state expands its Medicaid program, Kaiser Health News reported Jan. 6.

An HHS Office of Inspector General audit of seven Healthfirst Health Plan high-risk groups found several diagnosis codes submitted for use in CMS' risk adjustment program did not meet federal guidelines, resulting in more than $516,000 in overpayments within the…

CMS is proposing a new rule that aims to cut prescription drug costs, increase contract vetting and improve health equity, according to a Jan. 6 news release. 

Centene, Excellus Blue Cross Blue Shield and Kaiser Permanente all named new executives since Jan. 1. 

California's state Assembly is considering two bills to establish and fund universal healthcare in the state, according to a Jan. 6 Newsweek report.