Several major payer acquisitions have or closed or were announced in 2025. 13 deals to note: Kaiser Permanente is entering the Nevada market through a joint venture with Reno-based Renown Health and will form a new health insurance entity with…
Author: Rylee Wilson
Federal lawmakers have introduced a handful of bills aimed at speeding up prior authorization and cracking down on upcoding in Medicare Advantage. Not all of the introduced bills have been heard in committee. Here are eight proposals introduced in 2025…
New York state will bar insurers from compensating brokers for enrolling members in the state’s essential plan, beginning in 2026. The essential plan is available to low-income adults in New York who do not qualify for Medicaid. Andrew Biernant, vice…
UnitedHealth Group is complying with criminal and civil investigations into its Medicare Advantage business, the company said in a July 24 regulatory filing. The disclosure comes after The Wall Street Journal reported in May that the Justice Department has been…
Payer leaders need a flexible mindset, data know-how and big-picture thinking to succeed in 2025, according to more than a dozen executives. Becker’s reached out to 17 executives to learn what underrated skills set the best leaders apart. Like what…
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Humana has reintroduced a lawsuit challenging its Medicare Advantage star ratings. On July 18, U.S. District Judge Reed O’Connor dismissed the case without prejudice. Mr. O’Connor ruled that Humana had not exhausted all of its administrative appeal options when it…
Oscar Health is expecting to operate at a loss in 2025 as costs climb in the individual market. The company reported preliminary results for the second quarter of 2025 on July 22, expecting a loss from operations of $200 million…
The Medicare Part D market is facing an “uncertain future,” according to an analysis from KFF published July 16. The future of the Part D market depends on whether CMS extends the Part D premium stabilization program put in place…
ACA premiums are set to rise by 15% on average in 2026, The Wall Street Journal reported July 18. The Journal used data analyzed by KFF to report rate increases for the largest insurers in 19 states. BCBS Illinois is…
St. Louis-based Mercy is targeting closer partnerships with fewer organizations, Gavin Helton, MD, president of primary care at the system, told Becker’s. One of these partnerships is with Humana. Mercy and Humana opened their first collaborative 65Prime+ Clinics in Springfield…