by Jessica Casebolt | Mar 11, 2024 | Payers, Tea Leaves
Elevance Health and its state-based subsidiaries initiated a lawsuit against the federal government last week demanding the Centers for Medicare and Medicaid Services (CMS) undo technical changes to the star ratings program, recalculate scores, and redetermine quality...
by Jessica Casebolt | Mar 11, 2024 | Payers, Tea Leaves
Health insurance companies are expanding their coverage of bariatric surgery amid rising demand for pricey new weight loss drugs. Geisinger Health Plan and Blue Cross and Blue Shield carriers in Massachusetts, Michigan, and Vermont are among those easing access to...
by Jessica Casebolt | Mar 11, 2024 | Payers, Tea Leaves
According to a recent study, Medicare Part D overpays for certain over-the-counter (OTC) drugs that are covered when prescribed by a doctor. In addition, these higher costs filtered down to beneficiaries, and in some cases, their cost-sharing was also higher....
by Jessica Casebolt | Sep 11, 2023 | Payers, Tea Leaves
Cigna is exiting the Affordable Care Act exchange (ACA) in Kansas and Missouri and will depart from four counties in Arizona and Utah. A Cigna Healthcare spokesperson said the company’s goal is to provide access to high-quality care and offer significant value to its...
by Jessica Casebolt | Sep 11, 2023 | Payers, Tea Leaves
The Centers for Medicare & Medicaid Services (CMS) announced that the Medicare Shared Savings Program (MSSP) saved a net $1.8 billion in 2022 for accountable care organizations (ACOs), the second-highest annual savings since the program began 10 years ago....
by Jessica Casebolt | Sep 11, 2023 | Payers, Tea Leaves
The Biden administration is expected to disclose early next week the first 10 prescription drugs selected for Medicare price negotiations, ahead of a White House event Tuesday to celebrate the milestone. The announcement will mark a major step in a bid to lower drug...
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