A federal appeals court has ruled that state health plans must cover gender-affirming surgery for transgender beneficiaries, The Washington Post reported April 30. 

A co-branded Medicare Advantage plan offered by UnitedHealthcare and Walmart will come to an end amid the retailer's decision to close ​​its health centers and end virtual care services, Becker's confirmed April 30.

Payer executive moves reported by Becker's in 2024:

In written testimony provided ahead of two scheduled May 1 congressional hearings, UnitedHealth Group CEO Andrew Witty said it was his decision to pay ransom in an attempt to protect patient data stolen during the February cyberattack against one of its subsidiaries, Change Healthcare.

CMS and the NCQA are extending the quality data submission deadline for health plans by two weeks due to "extraordinary circumstances" caused by the cyberattack on Change Healthcare in late February.

The Texas Department of Health and Human Services provided Aetna with copies of other competitors' bids for Medicaid contracts in error, The Texas Tribune reported April 26. 

UCare posted an operating loss of $82.1 million in 2023, a decrease of more than 75% year over year, the Star Tribune reported April 26.

ConnectiCare is vacating 64,000 square feet of office space at its corporate headquarters in Farmington, Conn. because of the company's shift to a hybrid work style, CT Insider reported April 24.

CVS Health has acquired Medicare Advantage broker platform Hella Health. 

Centene has donated a $25 million claims processing facility to the Urban League of Metropolitan St. Louis, the St. Louis Post-Dispatch reported April 26. 

There are now more than 20 million Americans enrolled through the individual health insurance exchange marketplace (HIX) and growing. A product originally designed to provide coverage for the uninsured and those caught between having too much to qualify for Medicaid, but not quite enough to afford commercial coverage, is now setting its sights on the small group commercial market through ICHRA, or an individual coverage health reimbursement arrangement. This has the potential to be incredibly disruptive to providers given the negative impact this shift could have on overall reimbursement and provider margins.

When it comes to medical benefits management, finding the right partner is crucial. Safeguarding and improving members’ health while effectively supporting providers is paramount to a successful strategy. An exceptional partner should align with your goals and embody five key traits.

California lawmakers have introduced legislation again that would provide "comprehensive universal single-payer" health coverage for all 39 million residents of the state under a program called CalCare.

More mergers and acquisitions are a key part of Molina Healthcare's future strategy, executives told investors. 

Few states are adding coverage of GLP-1 drugs for weight loss, Centene executives said. 

Aetna and San Francisco-based Dignity Health have reached an agreement on a multiyear contract that allows the payer's members to remain in network with Dignity's facilities and providers in California, Arizona and Nevada.   

Centene reported nearly $1.2 billion in net income in the first quarter and a more than 18% decrease in Medicaid membership year over year, according to its first-quarter earnings posted April 26.

Payer executives anticipate building their equity and population management teams and leaning on AI and new technology in the coming years. 

Payers are trimming their workforces and cutting jobs due to financial or operational challenges, along with restructuring strategies. 

UnitedHealth Group CEO Andrew Witty is set to testify May 1 before a U.S. House subcommittee about the Feb. 21 cyberattack on the company's Change Healthcare subsidiary.