Payer

Blue Cross and Blue Shield of Oklahoma erroneously notified some members they would need to find new physicians or pay out-of-network rates, the Stillwater News Press reports.

While claims-level data for traditional Medicare has been available for several decades, the same light has not been shed on Medicare Advantage data, according to an opinion article published by JAMA.

Anthem will no longer cover monitored anesthesia care or general anesthesia for cataract surgery in most cases, according to a clinical guideline published Feb. 1.

In response to an October executive order by President Donald Trump, HHS proposed regulatory changes Tuesday that would extend the availability of short-term insurance plans.

New Mexico officials rejected claims its selection of managed care insurers to run its Medicaid program was biased, the Santa Fe New Mexican reports.

Two hospitals recently acquired by Peoria, Ill.-based OSF HealthCare from Chicago-based Presence are back in network with Blue Cross Blue Shield of Illinois as of Feb. 16, The News-Gazette reports.

Anthem completed its acquisition of America's 1st Choice, a privately held for-profit Medicare Advantage plan in Florida.

Colorado, Washington and Connecticut have joined California in investigating Aetna after one of the health insurer's former medical directors admitted under oath he never reviewed patients' medical records when deciding whether to approve or deny claims, according to CNN.

The Healthcare Financial Management Association asked 117 senior financial executives how hospitals, physicians and payers are feeling about using value-based payment models.

Anthem increased the number of "always pay" exceptions under its controversial discretionary emergency care policy.