Payers Partner With Communities of Color to Battle Racism
COVID-19 has disproportionately infected and killed people of color, causing many health care leaders to renew their focus on racism’s role in social determinants of health (SDOH). Since George Floyd was killed by...
Insurers Must Cover Only ‘Medically Necessary’ COVID Tests
As more employers turn to COVID-19 testing to see if employees are safe to return to the workplace, the Trump administration has clarified that insurers must cover only physician-ordered “medically necessary” di...
Reports: Medicaid MCOs Are ‘Dominant,’ Offer Quality Care
Two recent reports found that Medicaid managed care plans now enroll most Medicaid members, help keep costs and premiums low in the markets where they participate, and are competitive with commercial plans at the lo...
News Briefs
✦ A federal district judge upheld the Trump administration’s proposed rule to force hospital systems to reveal the prices they negotiate with insurers. The American Hospital Association (AHA), which brought a su...
In N.Y. Expansion, Highmark Will Absorb HealthNow Blues Plans With Chart: Highmark to Affiliate With Largest Insurer in Western New York
In a deal that the companies say was validated by the challenges of the COVID-19 pandemic, HealthNow New York Inc. revealed on June 16 that it will become part of fellow Blue Cross Blue Shield licensee Highmark Inc....
Telehealth Reimbursement Issue May Spark Lobbying Fight
Telehealth use has surged during the COVID-19 pandemic, and is likely to remain higher than it was before the crisis on a permanent basis. However, the difficult work of regulating and establishing rate structure fo...
Reporter’s Notebook: COVID-19 Pandemic Looms Large at 2020 AHIP Institute & Expo
Unsurprisingly, COVID-19 was a frequent topic of discussion during the 2020 America’s Health Insurance Plans Institute & Expo — an event held virtually because of the ongoing pandemic. Here’s a selection o...
LGBTQ+ Ruling Could Overturn HHS Final Rule, Experts Say
The Supreme Court’s June 15 ruling on LGBTQ+ workforce protections in Bostock v. Clayton County, Georgia, could supersede a recently finalized rule by HHS’s Office for Civil Rights (OCR) that stripped gender ide...
News Briefs
✦ CMS issued a proposed rule on June 17 aimed at making it easier for state Medicaid programs to enter into outcomes-based contracts with drug manufacturers. Among other policy revisions, the rule would allow manu...