Today's Top 20 Stories
6 Medicare Advantage plans audited for upcoding in the last six months
Audits published in the last six months found almost $32 million in overpayments across six Medicare Advantage plans, according to HHS' Office of Inspector General's semiannual report to Congress.Alignment Health names VP of Medicare growth
Medicare Advantage company Alignment Health has promoted Jason Han to vice president of Medicare growth, according to a June 5 LinkedIn post.Humana in the headlines: 8 updates
From being named in the top 50 of this year's Fortune 500 list, to Walgreens seeking to overturn a $642 million award in a drug-pricing dispute, here are eight updates on Humana that Becker's has reported since May 11:
FDA commissioner: Agency, CMS discussing Medicare weight loss drug coverage
The FDA and CMS are discussing how to handle obesity drugs in Medicare, Bloomberg Law reported June 7.UnitedHealthcare, Cigna halt policies after pushback
UnitedHealthcare and Cigna recently switched or paused policy implementations after receiving criticism from medical groups and other organizations.Optum home care program linked to fewer emergency, hospital visits for Medicare Advantage members: Study
Medicare Advantage patients who receive in-home health visits through the Optum HouseCalls program spend less time in the emergency room and inpatient hospital settings, according to a study by Yale Medicine and Optum researchers.Insurtechs still growing fast, but reserves eroding for some
Several carriers owned by insurtech companies significantly grew premiums written in 2022, but claims became a big challenge for two companies in particular — Bright Health and Friday Health Plans — according to a May 30 report from S&P Global.
Insurtechs ranked by total premiums received in 2022
奥斯卡健康收集premi的最高金额ums from its members in 2022 among all insurtechs, according to a May 30 analysis from S&P Global.6 Fortune 500 payers earn top marks for leadership
Fortune published its 2023 list of the largest corporations in the U.S. ranked by revenue for their respective 2022 fiscal years, which includes 80 healthcare organizations.Florida Blue names three market leaders
Florida Blue has named three market leaders in South Florida, South Florida Hospital News reported June 6.Medicare spending per beneficiary, year by year
Medicare spending per person grew by an average of 4.6 percent annually between 2000 and 2022, according to a June 6 analysis from KFF.
Elevance Health taps Empire BCBS CEO for top business role
Elevance Health has named Empire BlueCross BlueShield's president and CEO, Alan Murray, as its new chief business development officer for provider services.Cigna, Allegheny Health Network face July 1 split
Update: Allegheny Health Network signed a one-year in-network agreement with Cigna for commercial members that is effective July 1, the Pittsburgh Business Journal reported June 29.Judge certifies class action in Aetna, Optum 'dummy code' lawsuit
A federal judge in North Carolina certified class action status June 5 in a lawsuit alleging Aetna and OptumHealth Care Solutions conspired to use "dummy code" to make administrative fees appear to be billable medical charges.As Friday Health falters, its co-founder sues over alleged unpaid severance
Friday Health Plans, which is going out of business, is being sued by its co-founder and former COO David Pinkert for allegedly refusing to pay his severance package after he was terminated earlier this year.Fitch: Large payer finances stable, but pressures mounting in 2023
The nation's largest payers saw generally stable financial results in the first quarter of 2023 despite economic uncertainty throughout the broader healthcare industry, according to a June 6 analysis from Fitch Ratings shared with Becker's.SDOH interventions in primary care cost $60 per member each month: Study
The average cost of addressing social determinants of health is more than double what existing federal programs will cover, according to a study published May 30 in JAMA Internal Medicine.Former Humana executive named COO of behavioral health company
Lucet, which provides behavioral health services to health plans, has named former Humana executive Brian Doheny its COO.Humana now has 250 primary care centers for seniors
Humana's CenterWell Senior Primary Care business has opened its 250th center with plans to continue expanding over the next two years.9 payer CFO moves in the 1st half of 2023
Nine payer CFO moves reported by Becker's since January 1:
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