Payer

A recent audit of Tennessee Medicare found that of the $2 billion in certified public expenditures it claimed during the audit period of 2009 to 2014, $909.4 million was allowable while $1.1 billion was not.

Express Scripts is switching its formulary preference to insulin biosimilar Semglee, a move that it claims will save members $20 million in 2022. 

Four health insurance executives recently shared their top goals and priorities as they lead their organizations out of the pandemic. Here is what they told Becker's:

An Oct. 19 Avalere analysis of 2022 Medicare Advantage offerings found significant growth among nonmedical benefits.

UnitedHealthcare is partnering with Unified Women's Healthcare of North Carolina on an initiative to expand its group prenatal care model.

A letter from the Congressional Budget Office found that expanding the ACA — including tax credits, eligibility and Medicaid programs in holdout states — would cost $553 billion. 

A September HHS Office of Inspector General report found 20 insurers received about half of a $9.2 billion pool of suspicious Medicare payments over a year, but a new statement from the office ties the largest portion of those funds…

Anthem's third quarter earnings report demonstrated an uptick in revenue and raised its outlook for the third time this year. 

Ambetter, a Centene healthcare program, and Teladoc Health are partnering to launch a virtual access plan. 

Microsoft announced Oct. 19 that health insurers would be able to use its vertical-specific advertising, which is limited to certain industries.