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Kristen Smithberg is a Colorado-based freelance writer who covers commercial real estate, insurance, benefits and retirement topics for BenefitsPRO and other industry publications.
An air ambulance provider is accusing Anthem Blue Cross and Blue Shield of failing to pay more than 1,200 arbitration awards, adding another front to the expanding legal battle over the No Surprises Act's dispute resolution system.
A Milwaukee hospital alleges CVS used its control of a PBM, specialty pharmacy and third-party administrator to reduce reimbursements and retain savings intended to support patient care.
Nearly 70% of the estimate rests on payments above an insurer-calculated benchmark that a federal appeals court recently found could be artificially low.
The dispute-resolution system is protecting patients from unexpected bills, but researchers warn that rapidly rising awards and administrative expenses could increase health plan costs.
Capping commercial hospital payments at twice Medicare rates could substantially reduce employer health care costs while cutting more than $1 trillion from national health spending over a decade.