UnitedHealthcare will not cover remote physiologic monitoring when it is “unproven and not medically necessary,” including for Type 2 diabetes and most cases of hypertension. However, it will still cover monitoring for heart failure and hypertensive disorders of pregnancy, according…
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Health insurers spent the third quarter resetting pricing models and narrowing their product portfolios as medical cost trends remained elevated and Medicare Advantage headwinds intensified heading into 2026. UnitedHealth Group reported Q3 revenue of $113.2 billion, up 12% year over…
The Blue Cross Blue Shield system is made up of more than 30 independent and locally operated companies. While they share branding and licensing through the Blue Cross Blue Shield Association, each plan typically functions as its own entity with…
Baltimore-based Johns Hopkins is convening with health plans, health systems, policymakers and patients to further high-value care, according to a document shared with Becker’s on Nov. 7. “The purpose of this convening proposal is to create sustainable improvements in healthcare…
CMS is set to launch a pricing model in January that could reshape Medicaid drug costs by aligning them with rates seen in other high-income countries. Eight things to know: 1. The program allows participating drug manufacturers to offer Medicaid…
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North Carolina Insurance Commissioner Mike Causey, the North Carolina Chamber and Blue Cross NC shared the state’s new multiple employer welfare arrangement during a Nov. 4 news conference. The initiative, called Carolina HealthWorks, will be available to members of the…
The Idaho Department of Insurance has ordered UnitedHealthcare and PacificSource Health Plans to immediately cease and desist practices that the state says intentionally limited access to Medicare Advantage plans and cut broker commissions during the ongoing open enrollment period. The…
Today, nearly half of Americans struggle to afford basic healthcare, and patients wait an average of 38 days to see a doctor. At the same time, 80% of at-risk members remain unreachable. These barriers are unsustainable for members and health plans alike. While value-based care…
Blue Cross and Blue Shield of Alabama and the Medical Association of the State of Alabama agreed upon changes to prior authorization, according to a Nov. 4 news release. Over the past year, the insurer and the physician group collaborated…
A pair of U.S. senators sent a letter to CMS Administrator Mehmet Oz, MD, seeking answers for what they described as a “rushed launch” of the Medicare Advantage provider-directory tool. Sens. Jeff Merkley, D-Ore., and Ron Wyden, D-Ore., said in…