Healthcare industry’s resiliency to surging inflation is poised to ebb

Healthcare costs — unlike other goods and services — haven’t experienced immediate price increases amid record inflation. That’s starting to change.

By Hailey Mensik • Sept. 15, 2022

AMA joins plaintiffs in class-action lawsuit against Cigna

Jack Resneck, president of the AMA, said that the insurer is putting its “economic self-interest” ahead of physicians and patients in the Multiplan network.

By Sydney Halleman • Sept. 14, 2022

First Medicaid mobile mental health service to launch in Oregon

The program supports the 988 national hotline and is part of President Joe Biden's strategy to combat the country's mental health crisis.

By Susan Kelly • Sept. 14, 2022

UnitedHealthcare fires back, sues Envision for allegedly exaggerating patient claims

The insurer filed suit in the latest legal tussle between payers and physician staffing firms.

By Samantha Liss • Sept. 12, 2022

CVS enters into 4 new states for ACA exchange plans

The insurer has been bullish on expanding its ACA footprint since 2021, when its payer business Aetna said it would return to the exchanges after exiting them in 2017.

By Rebecca Pifer Parduhn • Sept. 9, 2022

Envision sues UnitedHealthcare over allegedly denied ER claims

Envision CEO Jim Rechtin called UnitedHealthcare’s alleged practice “cold, callous and inhumane,” according to a statement released Friday announcing a lawsuit was filed in a Tennessee federal court.

By Samantha Liss • Sept. 9, 2022

Robert Riney will lead Henry Ford Health

The new CEO and president has worked in almost “every operating unit in the organization” since he joined in 1978, according to a statement.

By Sydney Halleman • Sept. 8, 2022

Texas judge says HIV drug coverage requirement violates religious freedom

Texas Judge Reed O’Connor once again ruled against the Affordable Care Act. The health law requires employers to purchase insurance coverage that includes coverage for PrEP medication.

By Samantha Liss • Sept. 7, 2022

Physician groups urge CMS to prevent payment cuts, protect telehealth

Multiple groups representing doctors oppose Medicare payment reductions at a time when physician practices face escalating costs.

By Susan Kelly • Sept. 7, 2022

Walmart, UnitedHealth ink 10-year collaboration deal on value-based care

Ultimately, the goal is to serve hundreds of thousands of seniors and Medicare beneficiaries in value-based arrangements through multiple Medicare Advantage plans.

By Rebecca Pifer Parduhn • Sept. 7, 2022

Molina, Elevance nab Iowa Medicaid contracts on heels of California win

Iowa will soon have three health insurers to manage its $7 billion Medicaid program.

By Rebecca Pifer Parduhn • Sept. 1, 2022

Oscar loses big tech customer amid platform implementation snags

Health First’s decision to terminate their agreement — Oscar’s first full-service tech deal — will cause the insurtech to lose out on up to $60 million in revenue this year.

By Rebecca Pifer Parduhn • Aug. 31, 2022

Scan Group’s deal-maker, Binoy Bhansali, dishes on the importance of creating ‘competitive moats’ to accelerate growth

The vice president of corporate development explains the strategy behind the group's latest investments and how it will help the insurance unit compete in the long term.

By Samantha Liss • Aug. 31, 2022

Bush appointee tapped as Cigna’s first chief health officer

David Brailer is a founder and chairman of Health Evolution Partners, a healthcare investment firm, and is also vice chairman of the Duke-Margolis Health Policy Center.

By Hailey Mensik • Aug. 30, 2022

California probes Kaiser over enrollee access to mental health appointments

The investigation comes as a strike by therapists over staffing issues at Kaiser facilities in Northern California enters its third week.

By Susan Kelly • Aug. 29, 2022

Biden administration makes record-high investment in ACA navigators

The administration is pouring almost $100 million into organizations that help consumers navigate enrolling in Affordable Care Act plans in 2023.

By Rebecca Pifer Parduhn • Aug. 29, 2022

Cigna expanding ACA footprint to 3 new states in 2023

The expansion comes a little over a week since President Joe Biden signed a law extending subsidies for coverage and subsequently creating more stability in the exchanges.

By Rebecca Pifer Parduhn • Aug. 29, 2022

Congress finally eliminates Part D vaccine cost sharing: Medicare coverage is still broken

The Inflation Reduction Act leaves intact a peculiar split in Medicare vaccine coverage that discourages physicians from offering certain vaccines, argues former Moderna Vice President Richard Hughes.

By Richard Hughes • Aug. 26, 2022

Molina, Elevance, Centene win big with Medicaid contracts in California

The managed care organizations already held Medicaid contracts with the state, but the overhaul in counties served is causing one payer to consider appealing the proposed contracts.

By Rebecca Pifer Parduhn • Updated Aug. 29, 2022

Healthcare cost growth trails overall price hikes amid record inflation

Prices in the U.S. economy grew 8.5% in July compared to last year, while prices for medical care increased just 4.8%, according to a tracker from the Kaiser Family Foundation and Peterson Center on Healthcare.

By Hailey Mensik • Aug. 25, 2022

Judge blocks part of Idaho law, allowing physicians to perform abortions in emergencies

The ruling sides with the Biden administration, delivering a partial win for the DOJ in its first legal challenge since the Supreme Court ruled to overturn the constitutional right to an abortion.

By Samantha Liss • Aug. 25, 2022

Medicare Advantage lobby rebuts senator’s inquiry into ‘potentially deceptive’ marketing tactics

The Better Medicare Alliance is arguing that marketing materials for MA plans are already subject to “careful regulation” and adhere to a 53-page set of federal guidelines.

By Rebecca Pifer Parduhn • Aug. 24, 2022

4 California healthcare organizations reach $71M False Claims settlement

The organizations allegedly pocketed Medicaid adult expansion program funds meant to be returned to the state, according to a DOJ release.

By Hailey Mensik • Aug. 23, 2022

15M Medicaid enrollees risk coverage loss when COVID-19 health emergency ends, HHS reports

A disproportionate number of those who stand to lose coverage are children and young adults, according to the agency.

By Susan Kelly • Aug. 23, 2022

Federal regulators nix contested language in surprise billing final rule

The final rule removes the earlier requirement that arbiters must first presume that the median in-network rate is the appropriate payment. 

By Samantha Liss • Aug. 22, 2022