Today's Top 20 Stories
Georgia's Medicaid work requirement program starts July 1: 5 things to know
Georgia's Medicaid work requirement program is set to begin July 1. Here are five things to know about the program:BCBS Association sues Texas company over blue cross logo
The Blue Cross and Blue Shield Association is suing a specialty care management company in Texas for using a logo it says infringes upon and dilutes the BCBS brand.为什么奥斯卡健康公布了AI原型
Oscar Health published a glimpse into how the payer uses AI.
Why state employee health plans struggle to contain costs: 5 things to know
Health plans for state employees are often the largest commercial healthcare purchasers in their state, but these bargaining powers are not translating to lower costs, according to a report from the Center on Health Insurance Reforms at Georgetown University in Washington, D.C.UnitedHealthcare cuts out-of-pocket costs for virtual visits under some commercial plans
UnitedHealthcare is eliminating out-of-pocket costs for its "24/7 Virtual Visits" program for eligible members enrolled in fully insured employer-sponsored plans, starting July 1.Government watchdog wants CMS to up auditing of Medicaid managed care
The Government Accountability Office is urging CMS to consider adding Medicaid managed care programs to the scope of its recovery audit program.5 ways Medicare Advantage, fee-for-service differ on care for chronic conditions: Report
医生are Advantage beneficiaries with three common chronic conditions spend less time in the hospital than their counterparts in fee-for-service Medicare, an industry-backed report found.
More states could follow Michigan in pausing Medicaid disenrollments
Michigan said it would pause Medicaid disenrollments through July, and more states could follow, The Washington Post reported June 29.Centene CEO: Behavioral health costs on the rise
Centene CEO Sarah London says behavioral healthcare services are one of the areas where costs are growing the fastest.ProPublica: No one knows how often payers deny claims
No single source of information exists where consumers can view how often a specific health plan denies coverage for in-network and out-of-network claims, but state and federal agencies have the ability to change that, according to a June 28 ProPublica report.UCare names former Kansas Medicaid director, UnitedHealthcare leader as market president
UCare has tapped former Kansas Medicaid Director Jon Hamdorf, PhD, to lead its effort to win a Medicaid contract in the state.
Intermountain's Select Health rebrands
Select Health, the nonprofit insurance arm of Salt Lake City-based Intermountain Health, has rebranded with a new color palette, logo, and adjustment of its name, which was formerly SelectHealth.2 in 5 health plans, employers considering raising copays for prescription drugs
A majority of health plans and employers are considering at least one measure to change cost-sharing for prescription drugs, according to a report from the Pharmaceutical Strategies Group.10 key Elevance Health updates from the first half of 2023
Elevance Health said it will acquire Blue Cross Blue Shield of Louisiana in 2023, and the payer delivered double-digit growth in the first months of 2023.What 6 recent studies found about Medicare Advantage
Recent research on Medicare Advantage found enrollees with chronic conditions are not more likely to switch to original Medicare, and payment cuts do not slow the program's enrollment growth.Florida removing medically complex kids from Medicaid months earlier than promised
Florida has removed some children with complex medical needs from Medicaid through the redeterminations process, some advocates and families say, according to a June 28 Orlando Sentinel report.3 states naming new Medicaid directors
Three states named new Medicaid directors in June:UnitedHealthcare, New York hospital at impasse ahead of June 30 deadline
Syracuse, N.Y.-based St. Joseph's Hospital Health Center will go out of network with UnitedHealthcare if the two sides are unable to reach a new contract before July 1.The 2-midnight rule and Medicare Advantage: 6 things to know
There are major changes afoot for Medicare Advantage plans and when they are required to cover inpatient services in hospitals for their members. The changes are likely to present challenges for hospitals and how physicians document inpatient care.Former Highmark employee accused of stealing funds from member's health savings accounts
A former Highmark Health employee is facing criminal charges for allegedly attempting to or withdrawing nearly $90,000 from eight member's health savings accounts, the Pittsburgh Tribune-Review reported June 26.
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