Payer Issues Archives - Becker's Payer Issues

No Surprises IDR volume up 77% | Ex-Optum employee sentenced for fraud | Insurers' underwriting losses skyrocket | Henry Ford Health's MA membership jumps 46% | Blue Shield of Calif. cuts 60 jobs

No Surprises arbitration costs hit $22B + insurers see massive underwriting losses August 26, 2026 1. Former Optum director sentenced to 3 years in prison for defrauding company Full story 2. No Surprises dispute volume grows 77% in one year,…

3 new payer presidents | Disney, Starbucks among employers reducing benefits | States reject Medicaid GLP-1 deal | Insurer margin recovery dampened by high costs: Moody's | Union health plan sues OhioHealth

Big employers cutting benefits amid rising costs + states reject Trump’s Medicaid GLP-1 deal August 25, 2026 1. From Disney to Starbucks, big employers are pulling every lever to contain health costs Full story 2. Highmark taps Aetna exec to…

Payer CEO calls for prior auth ban | The AI jobs payers want to fill | Short term plan marketing up as ACA enrollment falls: Study | Cigna accused of behavioral underpayments | Ore. to launch state-based marketplace

A payer CEO’s call to ban prior auth + short term plan marketing surges amid ACA struggles August 24, 2026 1. Health insurer CEO: ‘Make prior authorization illegal’ Full story 2. The AI jobs health insurers are looking to fill right…

SCAN doubles down on 'hostile marketing' | Aetna to cut MA broker pay | Mount Sinai policy draws payer cease and desist | Employer care costs to rise 9.5% in '27: Aon | Ore. eyes ACA enrollment caps

An unconventional MA ad campaign will run again this fall and Aetna is cutting broker pay August 21, 2026 1. ‘We’re in wartime’: As major insurers continue pulling back on Medicare Advantage, SCAN places another contrarian bet Full story 2.…

BCBS Tenn. drops AI work tracking tool | Medi-Cal plans decry asset limit crunch | Humana taps new CMO | The latest in the No Surprises saga | Wide gaps in Medicare coverage knowledge: Survey

An insurer pivots on AI work tracking tool + the latest in the No Surprises saga August 20, 2026 1. BCBS Tennessee pivots away from AI tool that monitored employee work Full story 2. Medi-Cal plans brace for ‘devastating’ asset limit crunch…

Payers struggle to prove AI's ROI | Lowest-rated MA plans in '26 | Health Net names CEO | Alignment wants whistleblower suit tossed | 10 UnitedHealth updates

Payers are struggling to prove AI’s financial value + JD Power’s lowest-ranked MA plans August 19, 2026 1. Lowest-rated Medicare Advantage plans for member satisfaction in 2026: JD Power Full story 2. Health plan CFOs struggle to prove AI’s value:…

Top MA plans by market | Costco, SCAN partner | Investors renew fight against UnitedHealth | 5 forces driving up insurance costs in '27 | 10 recent billing fraud cases

Costco enters the MA market with SCAN deal + what’s driving insurance costs up in ’27? August 18, 2026 1. Investors renew fight against UnitedHealth, claiming $237M in insider stock sales Full story 2. 5 forces driving up health insurance…

UnitedHealth could see tax increase | Centene taps new CFO | Providence to shut down health plan | Where prior auth data still falls short | Hidden TPA fees increase employers' bills: Study

The IRS wants to increase UnitedHealth’s tax bill + Providence will totally shutter its health plan August 17, 2026 1. UnitedHealth disputes IRS proposal to boost tax bill Full story 2. Providence Health Plan to shut down after Medicare Advantage…

Mangione pleads guilty | Payers ranked by prior auth denials | Insurers among dozens flagged over gender care billing | Single-payer would save 114,000 lives per year: Study | Rising insurance costs hurting wage growth

Mangione says he shot UnitedHealthcare CEO + insurers targeted over gender care billing August 14, 2026 1. Luigi Mangione admits he shot UnitedHealthcare CEO Full story 2. Payers ranked by prior authorization denial rates Full story 3. OCD goes untreated for…

Insurers under siege | Employers' big PBM use declines | ICHRA market doubles: Report | Medicaid's rocky summer: 6 states to watch | 11 recent state payer fines

Insurers face growing scrutiny from all sides as costs rise + Employers embrace PBM alternatives August 13, 2026 1. Insurers are under siege heading into 2027 Full story 2. Employer use of ‘Big 3’ PBMs declines Full story 3. What…

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