Payer

MMM Healthcare, a Puerto Rico subsidiary of Elevance Health, received $59 million in net Medicare Advantage overpayments for 2017, according to an audit from HHS' Office of Inspector General published Aug. 14.

Ten states have passed laws reforming the prior authorization process, according to an Aug. 19 report from the American Medical Association. 

Medicare Advantage plans from Centene, Humana and UnitedHealthcare are among the lowest-rated plans for customer satisfaction in their markets in 2024, according to J.D. Power's annual Medicare Advantage Study.

Ten providers recently posted job listings seeking leaders in payer contracting and relations.

UPMC has the highest-ranked Medicare Advantage plan for customer satisfaction in 2024, according to J.D. Power's latest annual Medicare Advantage Study. 

A California bill aiming to reform prior authorization cleared one of the final hurdles for bills making their way to the governor's desk, according to the California Medical Association. 

Star ratings are an increasingly important factor in which plans Medicare Advantage beneficiaries choose, according to McKinsey and Company. 

Medicare Advantage plans are bracing for medical costs to keep rising, and preparing a "lobbying blitz" to defend the program in Washington, D.C. 

The average cost of employer-sponsored healthcare coverage is expected to jump 9% from 2024 to 2025, according to estimates from Aon Plc published Aug. 15. 

Humana will pay $90 million to settle allegations it submitted fraudulent bids for its Part D plans between 2011 and 2017.