Blue Cross Blue Shield plans
Signals mentioning Blue Cross, Blue Shield, BCBS.
90 signals
Signal volume
Signal mix
State footprint
- California 10
- Michigan 7
- Massachusetts 6
- Arkansas 5
- Idaho 4
- Louisiana 4
- Texas 4
- New Jersey 4
- Alabama 3
- Illinois 2
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Independence Blue Cross to pay $22.5M to resolve MA fraud allegations
Independence Blue Cross will pay to settle allegations it defrauded Medicare by inflating diagnosis codes for MA beneficiaries. The payer cited “industry-wide challenges” in applying MA risk adjustment standards.
Blue CrossBlue Cross Blue Shield plans · 36 signals · last 30 days -
11 payers exiting Medicare Advantage in 2027
Eleven payers are exiting the individual Medicare Advantage market for 2027, according to CMS data. Seven of the eleven are owned entirely or in part by health systems. Several other payers will stay in MA next year only through special needs plans, including Molina Healthcare, Horizon BCBS New Jersey, New York City-based MJHS Health System’s […] The post 11 payers exiting Medicare Advantage in 2027 appeared first on Becker's Payer Issues | Payer News .
Molina Healthcare + Blue Cross Blue Shield plans · 37 signals · last 30 days -
Independence Blue Cross to pay $22.5M over Medicare Advantage coding
Independence Blue Cross has agreed to pay $22.5 million to resolve allegations that it used inaccurate diagnosis codes to inflate its Medicare Advantage payments, according to a Sept. 30 Justice Department news release. The government alleged the insurer violated the False Claims Act in three ways for payment years 2017 through 2021. It says the […] The post Independence Blue Cross to pay $22.5M over Medicare Advantage coding appeared first on Becker's Payer Issues | Payer News .
Blue CrossBlue Cross Blue Shield plans · 36 signals · last 30 days -
Blue Shield of California must face mental health ‘ghost network’ claims
A federal judge allowed portions of a putative class action lawsuit against Blue Shield of California and Magellan, the insurer’s contracted mental health services administrator, to move forward over allegations that they published an inaccurate directory of mental health providers, according to a Sept. 23 court order. The plaintiffs are Blue Shield subscribers who alleged […] The post Blue Shield of California must face mental health ‘ghost network’ claims appeared first on Becker's Payer Is...
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
Medicare Advantage insurers ranked by county entries, exits in 2027
Many major health insurers are pulling back from some counties in 2027, while Singh Holdings, Blue Cross of Idaho and Devoted Health boosted their footprint. CMS released data Sept. 28 on the 2027 Medicare Advantage landscape, showing which counties insurers are serving or exiting next year. MA plan options are decreasing next year in 29 […] The post Medicare Advantage insurers ranked by county entries, exits in 2027 appeared first on Becker's Payer Issues | Payer News .
Devoted Health + Blue Cross Blue Shield plans · 37 signals · last 30 days -
BCBS Association names 3 new leaders
Blue Cross Blue Shield Association has named a chief transformation officer and hired two vice presidents, the organization said Sept. 29. Lynn Merritt has been promoted to executive vice president and chief transformation officer. She will oversee people experience, corporate strategy, communications and community, and serve as chief of staff to CEO Kim Keck. She […] The post BCBS Association names 3 new leaders appeared first on Becker's Payer Issues | Payer News .
Blue CrossBlue ShieldBlue Cross Blue Shield plans · 36 signals · last 30 days -
Texas investigating BCBS over possible denials, delays
Texas Attorney General Ken Paxton launched an investigation into Blue Cross and Blue Shield of Texas and its parent company, Health Care Service Corp., over potential denials and delays of medically necessary care, as well as prior authorization concerns. Mr. Paxton’s office announced the investigation Sept. 28. The office received reports that pointed to BCBS […] The post Texas investigating BCBS over possible denials, delays appeared first on Becker's Payer Issues | Payer News .
Blue Cross Blue Shield plans · 36 signals · last 30 days -
IBX names UnitedHealth, AmeriHealth Caritas alums as general counsel, CFO
Independence Blue Cross named Christine Kourouklis as executive vice president, CFO and treasurer and Brian Iaia as executive vice president, general counsel and corporate secretary, the company shared Sept. 24. “Christine and Brian bring the leadership and strategic insight we need to strengthen our organization, continue delivering for our members and customers and help shape […] The post IBX names UnitedHealth, AmeriHealth Caritas alums as general counsel, CFO appeared first on Becker's Pa...
UnitedHealthBlue CrossUnitedHealthcare + Blue Cross Blue Shield plans · 80 signals · last 30 days -
Penn Medicine, IBX plan 18+ surgery centers
Penn Medicine, Independence Blue Cross and Regent Surgical have partnered to develop at least 18 ASCs. The three organizations will form a new company to run the centers, which will be located across Penn Medicine’s service area in Pennsylvania, New Jersey and Delaware. The timing, scope and economic impact of the ASCs will depend on […] The post Penn Medicine, IBX plan 18+ surgery centers appeared first on Becker's Payer Issues | Payer News .
Blue Cross Blue Shield plans · 36 signals · last 30 days -
Hospitals say they’re losing the AI billing war. A new BCBS study suggests otherwise
The Blue Cross Blue Shield Association has put out a second round of research estimating that hospitals’ growing use of AI-assisted billing tools has added roughly $942 million in excess costs to the BCBS system over two years, contributing new data to the contentious “AI bot war” that’s been playing out across the industry. The […] The post Hospitals say they’re losing the AI billing war. A new BCBS study suggests otherwise appeared first on Becker's Payer Issues | Payer News .
Blue CrossBlue ShieldBlue Cross Blue Shield plans · 36 signals · last 30 days -
The high cost of health care guesswork, and how to address it
As costs continue to rise and visibility around health care choices remains clouded, employers are rethinking how their health plans work. Blue Cross Blue Shield of Massachusetts looks at the shift toward cost and quality transparency, and where its new plan, Beacon Blue, fits into that picture.
Blue Cross Blue Shield plans · 36 signals · last 30 days -
Texas hospitals sue Independence Blue Cross over denied claims
Despite a $2.8B settlement over BlueCard program disputes, five HCA-affiliated hospitals say the program still traps them in red tape.
Blue Cross TexasBlue Cross Blue Shield plans · 36 signals · last 30 days -
BCBS Minnesota taps chief investment officer
Blue Cross and Blue Shield of Minnesota named Todd Hedtke as treasurer and chief investment officer. Mr. Hedtke shared the update in a September LinkedIn post. He previously founded Integroz US, an investment architecture advisory firm and was CEO of Allianz Investment Management, according to his LinkedIn profile. The insurer’s former treasury vice president and […] The post BCBS Minnesota taps chief investment officer appeared first on Becker's Payer Issues | Payer News .
Blue Cross Blue Shield plans · 36 signals · last 30 days -
HCA-affiliated hospitals in Texas sue Independence Blue Cross over claim denials
Several HCA Healthcare-affiliated hospitals in Texas filed a lawsuit Sept. 11 against Pennsylvania insurer Independence Blue Cross over alleged claim denials. The plaintiffs include Methodist Healthcare System of San Antonio, St. David’s HealthCare, HCA Houston Healthcare North Cypress, The Woman’s Hospital of Texas and HCA Houston Healthcare Medical Center — all tied to Nashville, Tenn.-based […] The post HCA-affiliated hospitals in Texas sue Independence Blue Cross over claim denials appear...
Blue Cross Blue Shield plans · 36 signals · last 30 days -
STAT+: In a fight over denied claims, HCA sues out-of-state Blue Cross Blue Shield plan
Several Texas hospitals are suing an out-of-state Blue Cross for unpaid medical claims, highlighting the varying standards for whether care is medically necessary.
Blue Cross Blue Shield plans · 36 signals · last 30 days -
Blue Shield of California’s virtual program to reach 260,000 more members in 2027
Blue Shield of California is expanding its virtual care program, Virtual Blue, in January 2027, with total enrollment in plans containing the benefit to increase from 150,000 to more than 410,000 members. This boost includes 200,000 mid-size employer PPO members — enrolled through fully insured organizations with 101 to 3,000 employees — and 60,000 individual […] The post Blue Shield of California’s virtual program to reach 260,000 more members in 2027 appeared first on Becker's Payer Issues...
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
Air ambulance company suspends base operations amid BCBS reimbursement dispute
PHI Air Medical, an air ambulance company, suspended operations at the Red Bluff Air Medical Base at Red Bluff Airport in California amid reimbursement tensions with insurers. A Sept. 14 PHI news release shared with Becker’s specifically blamed Elevance Health, alleging more than 1,000 No Surprises Act federal arbitration awards that total about $30 million […] The post Air ambulance company suspends base operations amid BCBS reimbursement dispute appeared first on Becker's Payer Issues | Pay...
Elevance Health + Blue Cross Blue Shield plans · 48 signals · last 30 days -
Blue Shield of California to expand Virtual Blue program in 2027
The upcoming expansion will increase the plan’s total enrollment to more than 410,000 participants, executives say.
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
Hospital emerges from bankruptcy after inking 4-year deal with BCBS Alabama
Montgomery, Ala.-based Jackson Hospital exited bankruptcy Sept. 14, its president and CEO John Quinlivan confirmed to Becker’s. The hospital’s emergence from bankruptcy comes about one month after it signed a four-year agreement with Blue Cross Blue Shield of Alabama. The BCBS agreement was set to become active once the exit was complete. Jackson Hospital filed […] The post Hospital emerges from bankruptcy after inking 4-year deal with BCBS Alabama appeared first on Becker's Payer Issues | Pa...
Blue Cross Blue Shield plans · 36 signals · last 30 days -
BCBS Association names CFO
The Blue Cross Blue Shield Association has tapped Daniel Serrano to serve as CFO. The president and CEO of the BCBS Association, Kim Keck, announced the update Sept. 14 on LinkedIn. “With critical capabilities for this moment, including a practitioner’s orientation to data-driven financial management and a strong track record of aligning financial performance with […] The post BCBS Association names CFO appeared first on Becker's Payer Issues | Payer News .
Blue CrossBlue ShieldBlue Cross Blue Shield plans · 36 signals · last 30 days -
Prime Therapeutics taps CFO from Walgreens
Prime Therapeutics has named Manmohan Mahajan as chief financial officer. Mr. Mahajan most recently served as executive vice president and global CFO at Walgreens Boots Alliance, according to a Sept. 10 news release. Prime is collectively owned by 19 Blue Cross Blue Shield plans. The post Prime Therapeutics taps CFO from Walgreens appeared first on Becker's Payer Issues | Payer News .
Blue CrossBlue ShieldBlue Cross Blue Shield plans · 36 signals · last 30 days -
Blue Shield of California fined $800K over delayed member complaint resolution
California’s Department of Managed Health Care fined Blue Shield of California $800,000 due to grievance system issues that ultimately delayed complaint resolution. In California, health plans are required to maintain a grievance and appeal system to address member complaints in a timely manner. State law requires health plans to supply details regarding member complaints to […] The post Blue Shield of California fined $800K over delayed member complaint resolution appeared first on Becker's...
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
What’s next for Capital Blue Cross after expanding behavioral health resources
Capital Blue Cross took steps to broaden behavioral health access in recent years, contributing to a 9% reduction in related emergency department visits. Now, the insurer is looking to deploy similar strategies beyond behavioral health. In an upcoming episode of the “Becker’s Payer Issues Podcast,” Capital Blue Cross Chief Medical Officer Jeremy Wigginton, MD, broke […] The post What’s next for Capital Blue Cross after expanding behavioral health resources appeared first on Becker's Payer Iss...
Blue CrossBlue Cross Blue Shield plans · 36 signals · last 30 days -
Air ambulance company alleges Anthem owes $30M in No Surprises arbitration awards
Air ambulance operator PHI Health is suing Anthem Blue Cross and Blue Shield for allegedly refusing to pay tens of millions of dollars in binding arbitration awards issued under the No Surprises Act. The complaint, filed Aug. 31 in the U.S. District Court for the Southern District of Indiana, names Anthem alongside more than two […] The post Air ambulance company alleges Anthem owes $30M in No Surprises arbitration awards appeared first on Becker's Payer Issues | Payer News .
Elevance Health + Blue Cross Blue Shield plans · 48 signals · last 30 days -
Cambia Health Solutions, Arkansas Blue Cross affiliation set for October closure
The planned affiliation between Cambia Health Solutions and Arkansas Blue Cross Blue Shield has taken another step forward.
Blue Cross Blue Shield plans · 36 signals · last 30 days