Becker's Payer Issues | Payer News

Angle Health Co-founder and CEO Ty Wang thinks recent CMS and FDA initiatives will set a precedent that goes beyond Medicare. The “Advancing Chronic Care with Effective, Scalable Solutions Model” from CMS and “Technology-Enabled Meaningful Patient Outcomes for Digital Health…

CareFirst BlueCross BlueShield is suing CMS over its 2026 Medicare Advantage star ratings, alleging improper calculations cost the insurer an estimated $32 million in quality bonus payments. The lawsuit, filed Jan. 20 in the U.S. District Court for the District…

Jury selection in the federal murder trial of Luigi Mangione is scheduled to begin Sept. 8, U.S. District Judge Margaret Garnett said Jan. 23. The 27-year-old is accused of fatally shooting UnitedHealthcare CEO Brian Thompson outside the New York Hilton…

Minneapolis-based Hennepin Healthcare filed a notice of intervention Jan. 22 to interject itself into insurer UCare’s rehabilitation. UCare planned to hand over its Medicaid and ACA businesses to fellow insurer Medica in 2026 as its Medicare Advantage line discontinues. In…

The Montana Office of the Commissioner of Securities and Insurance hosted an administrative hearing Jan. 22 to address a data breach that affected BCBS Montana, owned by Health Care Service Corp. The hearing comes in the wake of a cybersecurity…

Alignment Health has named Adnan Mansour as chief digital officer. Mr. Mansour formerly served as senior vice president and chief information officer at Optum Insight, the data and analytics arm of UnitedHealth Group. At Alignment, he will focus on scaling…

Settling into 2026, prior authorization continues to be a contentious topic for payers, providers, lawmakers and other leaders. From piloting prior authorization in Medicare to governors pitching reforms, this year is bound to feature significant shifts. Here are seven prior…

A handful of states have declared emergency measures ahead of a winter storm slated to begin around Jan. 24. BCBS North Carolina is explicitly allowing early prescription refills, while Tricare — the U.S. Department of Defense’s health insurance program for…

CalOptima Health CEO Michael Hunn is retiring on Dec. 31, 2026.  Mr. Hunn was named interim CEO of the insurer in 2021 and CEO in 2022. His accomplishments include creating street medicine programs, establishing a department dedicated to implementing CalAIM…

The House of Representatives voted 341 to 88 on Jan. 22 to pass a government funding package that includes several long-sought healthcare provisions backed by hospital and provider groups. The three-bill “minibus” is part of a broader bipartisan legislative package…