Payer

Health insurance startup Oscar Health said it finally has the claims processing infrastructure to provide clearer physician payments — and turn a profit, according to CNBC.

Payer mix changes, like a shift toward more patients in government programs, coupled with rising healthcare costs, mean change is likely coming for America's healthcare payment system, according to the Beaverton Valley Times.

Highmark Blue Cross Blue Shield of Delaware sent out the wrong explanation of benefits forms to 507 members in March, according to the Delaware Department of Insurance. 

Blue Cross Blue Shield of North Carolina has eliminated LifeBrite Community Hospital of Stokes (N.C.) from its network, according to the Winston-Salem Journal.

CMS sent a letter to companies providing Medicare Part D plans May 17, calling for an end to gag clauses in contracts between insurers, pharmacy benefit managers and pharmacies.

In April, a federal judge denied Blue Cross & Blue Shield of Rhode Island's motion for summary judgment in an antitrust suit filed by Boston-based Steward Health Care. Last week, the judge denied the insurer's request to immediately appeal the…

Cigna and Express Scripts are planning a merger for several reasons, one of them being "the potential entry into the healthcare industry of significant new participants," according to a May 16 Securities and Exchange Commission filing.

New York City-based NYC Health + Hospitals joined Empire BlueCross BlueShield HealthPlus' Medicaid managed care network through a new contract.

Blue Cross Blue Shield of Massachusetts, the state's largest health insurer with 2.8 million enrollees, said its first quarter operating loss stemmed from the ACA's insurer fee and federal tax reform.

An independent federal study found President Donald Trump's planned expansion of short-term health plans will see higher enrollment and cost more than previously predicted, according to The New York Times.