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RADAR on Medicare Advantage
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As field marketing organizations and Medicare Advantage insurers filed multiple legal challenges to federal rulemaking, 2024 was a particularly litigious year for program stakeholders. Now, with the return of Donald...
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Using an extrapolation methodology that will allow the federal government to recoup billions of dollars in estimated overpayments to Medicare Advantage insurers, CMS this year intends to conduct Risk Adjustment...
HEALTH PLAN WEEKLY
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Alignment Healthcare, Inc. and Clover Health Investments Corp. each touted their Medicare Advantage membership growth and financial strength during the J.P. Morgan Healthcare Conference on Jan. 15....
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In the finalized version of the Biden administration’s last regulation governing the Affordable Care Act marketplaces, CMS made few changes from the version proposed in early October. Yet industry experts...
Radar On Speciality Pharmacy
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More than two-and-a-half years after it first brought a lawsuit against SaveOnSP, Johnson & Johnson has added two additional divisions of The Cigna Group to the case challenging its copay maximizer program....
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As more and more innovative therapies launch in the U.S., payers will continue to explore a variety of tactics in their coverage of those drugs, including carveouts, outcomes-based arrangements...
RADAR ON DRUG BENEFITS
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In a move that has raised the hackles of some stakeholders, Independence Blue Cross (IBX) on Jan. 1 implemented a policy stating that the Philadelphia-based health insurer will not cover nine drugs...
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The FDA’s accelerated approval pathway has become an increasingly popular way for drugmakers to get novel medications to market. However, the strength of clinical evidence from studies supporting...
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AIS Health is a publishing and information company that has served the health care industry for more than 30 years. Our mission is to provide our readers with an actionable understanding of the business of health care and pharmaceuticals. Our in-depth writing covers the companies, people, catalysts and trends that create the richly textured contours of the health care and drug industry. AIS Health maintains journalistic independence from our parent company, MMIT. We are committed to integrity in reporting and bringing transparency to health industry data.
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