Category: Payer Issues

It’s Time to Go Digital with Your Payments: Here’s Why

Electronic claim payment trends all point to one dynamic: faster turnaround. Simply put, businesses and consumers now expect near-immediate access to funds when they have been given notice of transfer. Luckily, that era of real-time digital payments is…

Excellus BCBS reaches tentative settlement over data breach

Excellus BlueCross BlueShield has agreed to a settlement for a class-action lawsuit over a 2015 data breach, according to fingerlakes1.com. 

BCBS Association names chief information security officer

The Blue Cross Blue Shield Association announced Chris Lugo as the organization’s vice president and chief information security officer. 

Labor Department makes mental health parity a ‘priority,’ works with HHS on enforcement

A Labor Department report found faults both in provider and payer mental health parity, and is now moving forward to further enforce parity and “correct those failures,” according to a Jan. 25 Marketplace report.

19 senators urge Medicare to cover at-home COVID-19 tests

Nineteen senators co-signed a letter to HHS and CMS urging the agencies to cover at-home COVID-19 tests for Medicare beneficiaries. 

Viewpoint: No Surprises Act controversy was never about price transparency

Although the price transparency elements of the No Surprises Act do shake up the payer-provider dynamic, the true controversy surrounding the act involves out-of-network rate mediation, Larry Levitt, Kaiser Family Foundation executive vice president fo…

Anthem BCBS names new Georgia leadership as Northside legal woes broaden

Anthem Blue Cross Blue Shield named Robert Bunch president Jan. 20, but the move comes as the payer potentially faces a new opponent in its legal battle against Atlanta-based Northside Hospital System, according to 11Alive. 

Exclusion from at-home COVID-19 test coverage puts Medicare recipients on the ‘back foot’

The coverage gaps created by the Biden administration’s at-home COVID-19 test coverage guidelines doesn’t solve barriers for a population that faces already-increased risks: Medicare beneficiaries, according to a Jan. 24 Kaiser Health News report. 

UnitedHealth Group: Telehealth is a ticket to driving health equity

The widespread adoption of telehealth is what UnitedHealth Group CMO Mary-Margaret Wilson, MD, calls “one of the most dramatic changes” in healthcare, but the next step is using that development to drive health equity. 

ONC seeks input on improving prior authorization

HHS’ Office of the National Coordinator for Health Information Technology is looking for public comments on prior authorization to help guide standards, implementation and certification.