Today's Top 20 Stories
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Judge allows lawsuit over UnitedHealth Medicare Advantage AI denials to move forward
A federal judge is allowing a lawsuit against UnitedHealth Group to partially move forward, which alleges the company used an artificial intelligence algorithm to wrongfully deny Medicare Advantage patients post-acute care. -
Trump administration targets ACA 'program integrity' with new rule, slashes navigator funding
The Trump administration is looking to target 'program integrity' within the Affordable Care Act marketplace with a new proposed rule, while also reducing funding for the ACA navigator program to $10 million. -
UnitedHealth, Amedisys pitch sale of 100+ clinics amid challenged merger
UnitedHealth Group and Amedisys have proposed selling a minimum of 128 home health and hospice facilities as part of their efforts to address competitive concerns arising from their $3.3 billion merger.
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Biden's CMS administrator joins think tank
Chiquita Brooks-LaSure, the CMS administrator during the Biden administration, is joining The Century Foundation, a progressive think tank, as a senior fellow. -
Payers contend with Inflation Reduction Act changes: 4 notes
Payers are navigating through the second year of major Inflation Reduction Act changes. -
Payers ranked by 2024 medical loss ratios
The country's largest payers reported year-over-year increases in medical cost ratios. -
Centene moves to dismiss star ratings lawsuit
Centene has moved to dismiss the lawsuit it filed challenging its Medicare Advantage star ratings in court.
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8 payers cutting jobs | 2025
Payers are trimming their workforces and cutting jobs due to financial or operational challenges, along with contract losses. -
15 payers among Forbes' best large employers | 2025
Blue Cross Blue Shield of North Carolina is the highest-ranked health insurer on Forbes' annual ranking of America's best large employers. -
'Very much in flux': UnitedHealthcare's data-driven approach to obesity care
UnitedHealthcare, in collaboration with the Health Action Council, has released a report analyzing the economic impact of obesity on employer's healthcare costs. -
Multiple Montana bills target prior authorization
Multiple prior authorization reform bills are in the works in the Montana state legislature, KFF Health News reported Feb. 13.
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Aetna reverses policy on nurse practitioner, midwife reimbursement
Aetna has reversed course on a policy change involving reimbursement rates for services provided by nurse practitioners and nurse midwives. -
Why this Medicare Advantage CEO takes calls from members
Atlanta-based Sonder Health Plans is rapidly expanding while aiming to keep its personalized service for members. -
CVS working 'tirelessly' to improve Aetna: 7 notes
CVS Health's new executives are working "tirelessly" to improve margins in the company's insurance business, CFO Tom Cowhey told investors. -
Payers ranked by 2024 profits
The nation's largest payers have filed their fourth-quarter earnings reports, revealing which recorded the largest profits in 2024. -
10 payers recently fined by states
Payers have faced state penalties over the last year for slow reimbursements, improper claims denials, or the sale of unapproved products. -
Cigna in the headlines: 8 updates
From announcing that it will tie executive pay to customer satisfaction to naming a new chief medical officer, here are eight updates on Cigna that Becker's has reported since Dec. 13: -
Humana's No. 1 Medicare Advantage priority: 5 notes
Humana expects its Medicare Advantage membership to decline by around 550,000 members in 2025. -
Humana posts $693M loss in Q4
Humana lost $693 million in the fourth quarter of 2024, according to the company's year-end earnings report published Feb. 11. -
UnitedHealth to pay $20M to settle emergency claims lawsuit from Labor Department
UnitedHealth Group reached a $20.25 million settlement with the U.S. Department of Labor on Feb. 7, resolving allegations that its subsidiary, UMR, improperly denied claims for emergency room visits and urinary drug screenings for thousands of patients.
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