Payer

A package of California bills aiming to streamline the prior authorization process recently passed out of Senate and Assembly health committees, the California Medical Association said April 28. The four-bill “Prioritizing Patients, Empowering Physicians” package was unveiled April 10 by…

Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites.  1. Akron Children’s Hospital seeks a director of reimbursement and payer analysis.  2. Albany…

For payers, drug formulary development and maintenance are essential for accurate reporting and tracking of prescription medications. An up-to-date and well-established classification resource can help payers and other stakeholders manage their drug formulary more efficiently. While several classification resources are…

2025 is shaping up to be a rocky year for payers’ finances.  At least seven Blue Cross Blue Shield plans reported losses in 2024, which could persist into 2025. In April, UnitedHealth Group cut its earnings guidance for 2025, citing…

A former Centene executive is suing the company over what he called “wrongful, anti-competitive, and bullying behavior” related to a noncompete agreement.  The plaintiff, who served as vice president of pharma relations and business strategy at specialty pharmacy AcariaHealth (acquired…

One in three Americans receives health coverage through one of 33 independent Blue Cross Blue Shield companies.   Here are 101 things to know about BCBS’ corporate structure, history and more.  This story was first published in April 2023 and last…

Centene posted $1.3 billion in net income in the first quarter, per its earnings report published April 25. Total revenues in the first quarter were $46.6 billion, up 15.4% year over year. The company reaffirmed its year-end adjusted EPS guidance…

UnitedHealth Group president and CFO John Rex was the highest-paid payer CFO in 2024.  Mr. Rex was paid $18.7 million in total compensation, according to proxy filings from the company.  Here’s how CFOs of the largest payers were compensated in…

Cigna’s board of directors has declared a $1.51 per share cash dividend to be paid June 18.  The dividend will be paid to shareholders of record as of the close of business June 3, according to an April 23 news…

North Dakota Gov. Kelly Armstrong signed a bill April 23 aimed at reforming the prior authorization process in the state.  The bill requires insurance plans to provide a decision within seven calendar days for nonurgent prior authorization requests and 72…