Payer

While the healthcare industry expected passage of the ACA to curb participation in Medicare Advantage programs, the opposite took place, according to Kaiser Health News.

Pennsylvania and seven major health insurance companies reached an agreement Oct. 12 to remove prior authorization requirements for opioid treatment.

Aetna agreed to pay a $365,000 penalty after the insurance provider inadvertently breached the privacy rights of hundreds of New Jersey residents, the state's Attorney General Gurbir Grewal said Oct. 11.

Blue Cross Blue Shield of Massachusetts is standing behind one of its board members after multiple union groups protested for her resignation outside the insurer's office Oct. 10, according to the Boston Herald.

The average premium for the most common silver plans on the federal ACA exchanges is down 1.5 percent for the 2019 coverage year, CMS said Oct. 11.

Humana faces a $700,000 fine from the Texas Department of Insurance due to its network adequacy, the department said Oct. 8.

CMS released its report card for Medicare Advantage and Part D prescription drug plans Oct. 10.

Kaiser Permanente Colorado, the largest insurer in the state, recorded losses of $65 million in the last three years, and says soaring hospital prices are to blame, according to The Denver Post.

WellCare Health Plans expanded its value-based provider network to include agilon health, a Long Beach, Calif.-based group with 14,000 physicians, the Tampa, Fla.-based insurer said Oct. 8.

There is little consistency in how U.S. insurance plans cover nondrug therapies for patients with back pain, according to a study published in JAMA Open Network.