Payer

CMS dropped a proposed regulation that would have required Medicare Advantage plans to return overpayments found during chart reviews over industry opposition, KFF reported Aug. 27. 

ACA enrollees in Cook County, Illinois have access to 14% of local physicians, according to an Aug. 26 analysis from KFF. 

The continued rising cost of healthcare is prompting many health plans to take a closer look at the value strong payment integrity programs can drive. 

Around 1 in 5 Medicare Advantage beneficiaries switch to traditional Medicare when their plans shut down, a study published Aug. 20 in JAMA Network Open found. 

CareFirst BlueCross BlueShield, Johns Hopkins University and Techstars will partner on an accelerator program to launch new healthcare-focused AI companies. 

Washington, D.C. has the highest Medicaid spending per enrollee, while Tennessee has the lowest, according to an Aug. 16 report from KFF.

As healthcare costs continue to rise, a growing number of employers are exploring alternative payment models such as direct contracting, where the employer contracts directly with a provider for employee care.

Alabama's state employee health plan is facing a projected loss of about $20 million in fiscal year 2025, the Alabama Reflector reported Aug. 22.

A federal judge has ruled that Blue Cross and Blue Shield of Minnesota must face a lawsuit from the U.S. Labor Department accusing the payer of incorrectly imposing a state provider tax on self-funded health plan customers and violating its…

Two-thirds of employers surveyed by the Business Group on Health cover GLP-1 drugs to treat obesity.