Settling into 2026, prior authorization continues to be a contentious topic for payers, providers, lawmakers and other leaders. From piloting prior authorization in Medicare to governors pitching ...

The Montana Office of the Commissioner of Securities and Insurance hosted an administrative hearing Jan. 22 to address a data breach that affected BCBS Montana, owned by Health Care Service Corp. The ...

The CEOs of most of the nation’s largest health insurers plan to lay blame for rising healthcare costs on hospitals, pharmaceutical companies and specialty providers during testimony before Congress ...

CareFirst BlueCross BlueShield is suing CMS over its 2026 Medicare Advantage star ratings, alleging improper calculations cost the insurer an estimated $32 million in quality bonus payments. The ...

The House of Representatives voted 341 to 88 on Jan. 22 to pass a government funding package that includes several long-sought healthcare provisions backed by hospital and provider groups. The ...

The CEOs of the nation’s largest health insurers drew the ire of lawmakers on both sides of the aisle during congressional hearings that went for more than nine hours Jan. 22 over industry ...

CVS Health reported progress on key affordability and access initiatives, including reduced prior authorization burdens and expanded biosimilar adoption. The company has about half as many medical ...

Missouri Republican state Sen. Benjamin Brown introduced a bill Jan. 7 to slash prior authorization requirements for providers. Providers would be exempt from prior authorization unless the insurer or ...

BCBS Minnesota appointed Allysia Jenkins, BSN, RN, DNP, as vice president of health solutions and Benjamin Pepin as vice president of affordability, according to a Jan. 22 news release. Dr. Jenkins’s ...

Founded in 2023, Texicare — a Texas Mutual affiliate — offers health coverage to small businesses throughout the state. Texicare President and CEO Meredith Duncan previously worked at Aetna, Bright ...

Hospital leaders are getting long-awaited clarity from Congress this week as lawmakers unveil a bipartisan healthcare deal tied to a broader government funding package. The 771-page proposal includes ...

CMS is moving to replace four legacy Medicare claims platforms. Now, it is seeking a vendor to design one platform that would assume all four systems’ responsibilities. In a Jan. 8 request for ...