Becker's Payer Issues | Payer News

CMS has finalized the Global Benchmark for Efficient Drug Pricing (GLOBE) Model, a mandatory payment model that will tie Medicare Part B drug rebates to prices paid in 19 reference countries, according to a Sept. 30 CMS news release. Here…

While some payers are slimming down their Medicare Advantage reach, some are betting big on special needs plans. SNPs cover dually eligible Medicaid individuals (D-SNP), those with chronic conditions (C-SNP) and those needing long-term care (I-SNP). CMS released data Sept.…

CMS Administrator Mehmet Oz, MD, is urging employers to consider an alternative to traditional group health plans that allows workers to select their own individual insurance coverage. Speaking Sept. 30 at an event in Austin, Texas, Dr. Oz promoted CHOICE…

A federal judge has thrown out most of a securities fraud lawsuit brought by the country’s largest pension fund against UnitedHealth Group, but will let claims that the company misled investors about previous asset sales move forward. The California Public…

Dallas-based Baylor Scott & White Health reported operating income of $1.5 billion (8.3% margin) during the fiscal year ending June 30, 2026, down from a $1.7 billion operating gain (10% margin) in the previous fiscal year, according to financial statements…

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…

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,…

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…

Tom Curtin was named executive vice president of Kaiser Permanente’s National Health Plan after serving as its interim leader since May. In the role, effective immediately, Mr. Curtin will lead health plan strategy and operations with a focus on growth,…

UnitedHealthcare is withdrawing from international private medical insurance in the Americas, Europe, Africa and the Middle East, the insurer confirmed to Becker’s Sept. 29. According to a Cigna news release, UnitedHealthcare Global will exclusively recommend the Cigna Global Health Benefits…