America’s Health Insurance Plans (AHIP) is launching a new initiative to overcome social determinants called Project Link, the organization announced at their 2019 AHIP Institute and...
Blue Cross Blue Shield Association president and CEO Scott Serota will be retiring at the end of 2020, the major healthcare payer has announced.
Serota leaves behind a 23-year history at BCBSA,...
CMS is streamlining the Medicaid review process and making it more transparent, efficient, and less burdensome in an effort to speed up approval times for state programs.
“At CMS, we are making...
The Department of Veterans Affairs (VA) has partnered with Cigna to improve patient safety and care quality for chronic pain patients at risk for opioid abuse.
The partnership aims to educate...
Sutter Health, a California-based, non-profit benefit organization, has agreed to pay $30 million to settle allegations that its affiliated entities submitted false information about the health status...
North Dakota Governor Doug Burgum has signed a bill that will establish a reinsurance pool for the state’s individual health insurance market.
The North Dakota House of Representatives passed...
The Federal Trade Commission (FTC) is suing Surescripts, alleging that the health information exchange company is using illegal vertical and horizontal restraints to maintain its monopoly over two key...
Humana is launching a new value-based care oncology program designed to deliver integrated cancer care for Humana Medicare Advantage and commercial members.
The national Oncology Model of Care (OMOC)...
One of the largest healthcare fraud schemes investigated by the FBI and HHS and prosecuted by the Department of Justice resulted in $1.2 billion in losses and charges against 24 executives of...
Centene will fund up to $100 million in precision medicine research at the Washington University School of Medicine in an effort to accelerate treatment for Alzheimer’s disease, breast cancer,...
UnitedHealthcare is expanding its Medicare Advantage bundled payment program, offering providers in more than 30 states the opportunity to participate in these models for their patients enrolled in MA...
Cigna and Express Scripts have launched a program to reduce out-of-pocket insulin costs for patients with diabetes.
The Patient Assurance Program will ensure eligible people with diabetes in...
CMS has finalized new Medicare Advantage and Part D payment policies for 2020 that will increase competition among health plans, leading to higher quality care at lower costs.
The changes will...
Certain states and medical specialties account for larger shares of out-of-network claims and balance bills for inpatient hospital admissions, according to a study conducted by the Health Care Cost...
The National Association of ACOs (NAACOS) has urged the CMS Innovation Center to improve transparency throughout the process of releasing and updating alternative payment models.
“While we...
CMS has introduced new Medicare Part D patient safety policies that will address the opioid epidemic while still preserving medically necessary access to pain management therapies.
The new policies...
UnitedHealthcare recently announced that it has invested more than $400 million to address the social determinants of health and increase affordable housing access for people in underserved...
Approximately 11.4 million consumers either selected or were automatically re-enrolled in Affordable Care Act (ACA) health insurance exchange plans during the open enrollment period in 2019, according...
CMS has launched a Compliance Review Program to ensure that health plans, payers, providers, and other covered entities are complying with HIPAA Administrative Simplification rules for electronic...
Blue Shield of California’s Narcotic Safety Initiative has achieved a 56 percent reduction in opioid use among members with chronic pain, surpassing its 2018 year-end goal by six percentage...
