Payer

CMS' encounter data continues to lack identifiers for ordering providers, which are used to identify potential fraud and abuse, according to a report from HHS' Office of Inspector General. 

About 12 million people who have lost their job in recent months have also seen their employer-sponsored health insurance cut off, according to research from the Economic Policy Institute. 

The following payer executives changed their positions in August.

Aetna Health of California must stop using national standards to deny payment for emergency room claims, the California Department of Managed Health Care ordered Aug. 25. 

An analytics firm that found Tennessee's State Group Insurance Program is overcharging providers may face a lawsuit from the state's largest health insurer. 

While most private health insurers moved to waive member cost-sharing for COVID-19 testing and treatment, many of those waivers are expiring in coming months.

UnitedHealthcare is changing which medication for HIV prevention it considers a covered option for members.

Centene Corp. and its subsidiaries underpaid a group of emergency room physicians who are part of TeamHealth, according to an Aug. 18 verdict.

Devoted Health, a "payvidor" that provides Medicare Advantage coverage and home-based healthcare services, is growing its workforce, according to Mainebiz.

Six CEOs at the largest publicly traded managed care insurers in the nation earned more than $15 million each in 2019, according to S&P Global Market Intelligence.