Payer

In tandem with the Maryland Department of Health, Optum announced a recoupment schedule on Nov. 17 for behavioral health providers to refund overpayments to state Medicaid and health programs. 

Blue Cross Blue Shield of Massachusetts and wellness consulting firm National Fitness Campaign will build 15 public outdoor fitness courts across the commonwealth next year.

Blue Cross Blue Shield of Illinois members will no longer be able to receive in-network rates at Springfield Clinic locations as of Nov. 17 after the parties' contract negotiations fell through.

Direct-to-patient healthcare marketplace Sesame is aiming to cut care costs down by using direct arrangements with providers to avoid administrative fees traditionally imposed by insurers.

EasyHealth secured $135 million in series A funding to back its approach to battling the "information gap" on Medicare insurance recipients.  

About halfway through 2021's open enrollment period, 88 percent of Medicare Advantage plans purchased on marketplaces have $0 premiums, according to a Nov. 18 survey from eHealth.

The Blue Cross Blue Shield Association has named Tim Vines its chair of the board of directors, the association announced Nov. 17.

Here are five updates on legal actions involving payers:

As the federal government explores a proposed 10 percent funding cut to Medicare, Texas physicians are wary that the move could severely impact patient options. 

The Biden administration issued an interim final rule Nov. 17 that requires health plans to report prescription drug and health coverage costs.