Friday, May 17, 2024: Payers

Kansas has awarded new contracts in its more than $4 billion Medicaid managed care program to plans operated by incumbents UnitedHealth and Centene. CVS, however, was displaced by newcomer Healthy Blue, a plan majority owned by Elevance. Kansas’ Medicaid program,...

Tea Leaves: January 18, 2024: Payers

To combat growing criticism of prior authorization delays by payers, the Centers for Medicare & Medicaid Services (CMS) finalized a rule Wednesday that requires health plans to send prior authorization decisions within three days for urgent requests and seven days...

Tea Leaves: January 17, 2024: Payers

Wages have not been able to offset the rising costs of premiums for workers with employer-sponsored coverage over the last three decades, with Black and Hispanic employees hit particularly hard by this development, according to a study in JAMA Network Open. The...

Tea Leaves: January 12, 2024: Payers

The Blue Cross Blue Shield Association will lead an effort to improve maternity care in about 600 acute care and pediatric hospitals across the nation, including a push to address racial and ethnic disparities. Health equity in maternal care will be added to the list...

Tea Leaves: January 10, 2024: Payers

The Centers for Medicare & Medicaid Services (CMS) approved New York’s amended Medicaid section 1115 demonstration on Tuesday, spurring the agency to invest in behavioral health and health equity initiatives. The amendment, which expires March 31, 2027,...

Tea Leaves: January 9, 2024: Payers

Walgreens has agreed to pay $360 million to health care insurer Humana to settle a lawsuit claiming that the retail pharmacy giant for years overcharged for prescription drug reimbursements. The settlement ends a legal dispute that began when Humana accused Walgreens...