Investing in digital and artificial intelligence technologies is a higher priority for payer CFOs than for their health system counterparts, according to a July 10 report from Deloitte.
Payer
CMS published updated star ratings for dozens of Medicare Advantage plans, and a federal judge paused a new CMS regulation that would cap the amount insurers can pay brokers who sell their plans.
Blue Cross and Blue Shield of Louisiana has moved its care management processes and several provider services to the Epic Payer Platform.
Two Blue Cross Blue Shield plans have now lost in federal court for terminating employees that refused to get vaccinated against COVID-19, and other insurers are facing similar lawsuits.
As insurers continue to face major financial pressures related to covering weight loss drugs, many are steering more patients toward bariatric surgery to achieve similar results.
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UnitedHealth Group and several of the company's leaders are facing a shareholder derivative lawsuit alleging they failed to disclose that the Justice Department opened an antitrust investigation into the company.
Medicare Advantage organizations are facing major challenges, including rising utilization rates, reduced reimbursements, and an evolving regulatory landscape.
Medicare Advantage plans received $50 billion in payments between 2018 and 2021 for "questionable diagnoses" insurers added to medical records, a Wall Street Journal investigation published July 8 has found.
Payers have faced state penalties over the last year for slow reimbursements, improper claims denials, or the sale of unapproved products.
Here are five updates on prior authorization, Becker's has reported since June 18: