Payers maintain one of the few remaining ways of holding accountable the 15 percent of U.S. adults unvaccinated against COVID-19: leveraging insurance surcharges and discounts, columnist Glenn Altschuler wrote in a Jan. 10 column for The Hill.
Category: Payer Issues
New Hampshire 5th state to settle with Centene over pharmacy benefit services
New Hampshire’s Justice Department announced a $21 million settlement with Centene and two of its subsidiaries — Granite State Health Plan and NH Healthy Families — over the payer’s pharmacy benefit services.
Court rules against UnitedHealth subsidiary, orders $20M payout
A California court ruled against United Behavioral Health, a UnitedHealth Group subsidiary, ending a multiyear class-action lawsuit and requiring the provider pay out over $20 million, according to Bloomberg.
Viewpoint: Build Back Better the ticket to universal healthcare no one is talking about
While conversations around partisanship, funding and education surround President Joe Biden’s Build Back Better Act, spectators are largely ignoring how close the bill brings the U.S. to reaching universal healthcare, Washington Post columnist Katherin…
Healthfirst received $5.2M in overpayments, OIG audit finds
An HHS Office of Inspector General audit of seven Healthfirst Health Plan high-risk groups found several diagnosis codes submitted for use in CMS’ risk adjustment program did not meet federal guidelines, resulting in more than $516,000 in overpayments …
CMS releases Medicare Advantage, Part D proposed rule: 7 changes to know
CMS is proposing a new rule that aims to cut prescription drug costs, increase contract vetting and improve health equity, according to a Jan. 6 news release.
5 recent payer exec moves
Centene, Excellus Blue Cross Blue Shield and Kaiser Permanente all named new executives since Jan. 1.
California Democrats pitch plan for taxpayer-funded universal healthcare: 7 things to know
California’s state Assembly is considering two bills to establish and fund universal healthcare in the state, according to a Jan. 6 Newsweek report.
Humana slashes 2022 Medicare enrollment outlook
Humana is nearly halving its 2022 estimates for Medicare Advantage enrollment to reflect “higher than anticipated” terminations during the last enrollment period, according to a Jan. 6 SEC filing.
7 medical claims expected to increase in 2022
Payers should brace for an increase in joint pain, cardiomyopathy and diabetes-related claims throughout 2022, according to a report from health insights company Prealize.
