Aetna Health of California must stop using national standards to deny payment for emergency room claims, the California Department of Managed Health Care ordered Aug. 25. 

An analytics firm that found Tennessee's State Group Insurance Program is overcharging providers may face a lawsuit from the state's largest health insurer. 

While most private health insurers moved to waive member cost-sharing for COVID-19 testing and treatment, many of those waivers are expiring in coming months.

UnitedHealthcare is changing which medication for HIV prevention it considers a covered option for members.

Centene Corp. and its subsidiaries underpaid a group of emergency room physicians who are part of TeamHealth, according to an Aug. 18 verdict.

Devoted Health, a "payvidor" that provides Medicare Advantage coverage and home-based healthcare services, is growing its workforce, according to Mainebiz.

Six CEOs at the largest publicly traded managed care insurers in the nation earned more than $15 million each in 2019, according to S&P Global Market Intelligence.

Health insurer startup Oscar will run a Medicare Advantage plan with two health systems in Florida, the organizations said Aug. 19.

The COVID-19 pandemic has changed how large employers are planning for healthcare costs and benefits for their employees, according to a survey from the Business Group on Health.

Cleveland Clinic and Aetna are forming an accountable care organization that includes the launch of a co-branded insurance plan designed for employers in Northeast Ohio and expanded access to the health system for second opinions and heart care. 

Anthem and Quest Diagnostics will collaborate on outcomes-based programs under a new partnership, the organizations said Aug. 17.  

Antitrust claims filed by Humana against Mallinckrodt over price hikes the pharmaceutical company made on an anti-inflammatory drug can advance, a federal judge said Aug. 14.

Cape Girardeau, Mo.-based Saint Francis Healthcare System debuted a direct contracting health option Aug. 17. 

America's uninsured population has fluctuated as the COVID-19 pandemic caused many to lose health insurance due to layoffs and furloughs.

Here are 10 payers that are returning premium revenue to members due to lower healthcare costs during the COVID-19 pandemic. 

Highmark Health, the health insurer that owns Pittsburgh-based Allegheny Health Network, continued to see strong finances in the first half of this fiscal year despite AHN's $116 million operating loss.

The following payer executives changed their positions in August.

UnitedHealthcare will be replacing paper checks with electronic payments throughout the rest of this year, the health insurer said in an August bulletin.

A radiology lab in New Jersey sued Cigna Aug. 12 over reimbursement for COVID-19-related services, according to Law360.

Cigna appointed Noelle Eder its global CIO, effective Sept. 14.