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Category: Payor

Home / Payor
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Payor

Blue Cross NC Responds to Announcement from Mission Health

Mission Health issued a press release announcing their plans to remain in-network for Blue Cross and Blue Shield of North Carolina (Blue Cross NC) customers enrolled on an ACA plan in 2018. …

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Payor

Blue Cross Blue Shield groups weigh potential cost sharing strategies

The Wall Street Journal reports that Highmark Inc. is, with other health groups, part of very early-stage discussions regarding “combining some operations to share costs.” The talks apparently include Blue …

Payor

Medicare to cut payments to employer-sponsored Advantage plans

A new federal proposal would slash over payments made to Medicare Advantage plans sponsored by employers and unions years after an advisory board recommended the policy. The CMS proposed terminating …

Payor

Highmark to cut doctors’ payments for ACA plans

Citing an estimated $500 million loss last year on health insurance plans sold on the Affordable Care Act marketplace, Highmark Inc. said Friday it plans to reduce what it pays …

Payor

UPMC analysis contends Highmark no longer top insurer in Western Pa.

More people in Western Pennsylvania now have health insurance from UPMC than from Highmark Inc., according to a UPMC analysis, marking a potential milestone in the rivalry between the nonprofits. …

Payor

Proposed Medicare loss is a gain for insurers

When is a loss a gain? It seems the answer is when the loss wasn’t nearly as bad as expected. That’s what major health insurers discovered when the Centers for …

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Payor

Justice Department investigating Humana billing practices

Humana Inc. reports that it is cooperating with a Department of Justice inquiry into whether it exaggerated the severity of elderly patients’ illnesses to generate higher Medicare reimbursements. The Louisville, …

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Payor

Highmark offers grace to members on out-of-network rate

Highmark Inc. is offering a second chance to members who stray out of network, but just once. The health insurer will cover care that is provided out of network just …

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