Payer

Patients’ high demand for behavioral health services since the pandemic is no secret, but Bill Harlan — vice president of behavioral health and health engagement of Canton, Mass.-based Point32Health — said the insurer’s provider partners have also faced challenges, like…

With its second Program of All-Inclusive Care for the Elderly center now open in South Los Angeles, SCAN Group is pressing ahead with a care model that faces steep regulatory challenges. The new 33,000-square-foot facility in Compton will provide low…

CMS is delaying a Medicare Advantage supplement benefits notification rule that was slated to start in 2026. The pause affects MA organizations that would have sent annual notifications between June 30 and July 31 to enrollees about unused benefits, according…

GLP-1 costs have stayed nearly flat in recent years when accounting for rebates, according to an analysis from the Delaware Department of Insurance’s Office of Value-Based Health Care Delivery. Based on this finding, Trinidad Navarro, the state’s insurance commissioner, questioned…

UnitedHealthcare is expecting 78% of its Medicare Advantage membership to be enrolled in plans rated 4 stars or above in 2026. The company told regulators on Sept. 8 that while star ratings data is not yet final, it intends to…

Blue Cross and Blue Shield of Minnesota has tapped Erin Barney as president of commercial markets and Jamie Reuter, PharmD, as vice president of pharmacy solutions, according to a Sept. 8 news release.  Ms. Barney will supervise strategy and execution…

Idaho’s health plan for state employees, retirees and their dependents is dropping coverage for GLP-1s prescribed for weight loss, effective Nov. 1. The change does not impact GLP-1 coverage for diabetes, the state said Sept. 5. The new policy is…

A settlement has been finalized in a decadelong lawsuit that claimed Aetna and Optum used misleading billing practices to conceal administrative fees for chiropractic and physical therapy services as medical charges. Chief Judge Martin Reidinger of the federal Western District…

For more than two years, Becker’s has reported on the intensifying trend of Medicare Advantage reimbursement fights between hospitals and insurers that has contributed to a dizzying and ever-changing environment for older adults to navigate each enrollment period.  Now, that…

Elevance Health is cutting some Medicare Advantage plans — affecting about 150,000 members next year — and fully exiting standalone Part D plans in 2026. “We made the decision to exit some plans and counties where we did not see…