Payer Issues Archives - Becker's Payer Issues

Trump pitches $500 ACA refunds | Health Net faces sanctions | Optum Insight taps AI chief | 30 systems dropping MA plans | Dignity sues Medi-Cal plan, claiming $30M in unpaid bills

Trump pitches ACA refund checks ahead of midterms + Calif. may sanction a Centene subsidiary September 11, 2026 1. Trump pledges $500 checks to 1 million people for ACA ‘overcharges’ Full story 2. Optum Insight names Amazon alum as chief AI…

UnitedHealth CFO talks 'tough' MA decisions | Aetna's Medicare CMO departs | Blue Shield of Calif. fined over delayed complaint resolutions | Former CVS exec wins Dem nomination for RI governor | Prime Therapeutics taps CFO

UnitedHealth CFO talks ‘tough decisions’ in MA + former CVS exec advances in RI gov race September 10, 2026 1. UnitedHealth CFO says ‘tough decisions’ in Medicare Advantage are paying off Full story 2. Blue Shield of California fined $800K over…

Optum sells interest in Fla. clinics | Lawsuit alleges Anthem owes $30M in IDR awards | 6 states finalize '27 ACA rates | Insurer profits not driving up premiums: Study | MGB Health Plan drops Dana-Farber from MA network

Anthem is accused of not paying $30M in IDR awards + ’27 ACA rates start taking shape September 9, 2026 1. Optum sells interest in Florida clinics: Report Full story 2. Air ambulance company alleges Anthem owes $30M in No…

Cambia, Ark. BCBS deal approved | Humana sues over $7.3B weedkiller settlement | Lawmaker probes IDR arbiters | What drives success for retail-branded MA plans? | How 10 payer execs drive innovation

BCBS consolidation continues + a closer look at retail-branded Medicare Advantage plans September 8, 2026 1. Arkansas BCBS, Cambia receive green light for affiliation Full story 2. A tale of 2 retailers: What drives success for co-branded Medicare Advantage plans…

Democrats eye expanding Medicare | ICHRA gets a rebrand | 8 recent MA contract freezes | CareFirst sues over trademark infringement | Cigna employees ink GLP-1 coverage petition

Democrats are weighing big healthcare goals ahead of midterms + ICHRA gets a rebrand September 4, 2026 1. Democrats in talks about expanding Medicare, breaking up large insurers: Report Full story 2. CMS rebrands ICHRA Full story 3. GLP-1s are…

Health Net exits commercial group market | State-run exchange enrollment down 8.5% | Site-neutral imaging pay could save $9.7B: BCBSA | Part D plans paid $587M for mislabeled OTC drugs: OIG | Self-pay hospital visits spike

A Centene subsidiary makes a major market exit + ACA enrollment continues to fall September 3, 2026 1. Centene’s Health Net to exit commercial group market in California, Oregon Full story 2. Part D plans paid $587.7M for over-the-counter drugs…

Ohio Chamber sues UHC | Texas investigating TriWest | 6 new reimbursement changes this month | Elevance-BCBS venture to exit La. Medicaid | Johns Hopkins Health Plans taps interim CEO

Ohio Chamber says UHC poached its members + Elevance exits another Medicaid program September 2, 2026 1. Ohio Chamber sues UnitedHealthcare over alleged effort to poach members Full story 2. 6 payer reimbursement changes to know in September Full story…

UHC pushes 30% prior auth reduction | MA plan hit with enrollment freeze again | 5 healthcare fights on the ballot | Cuban: Healthcare contracts are like 'Fight Club' | HDHPs don't slow long-term spend: Study

The nation’s largest insurer cuts prior auth requirements + healthcare top of mind ahead of midterms September 1, 2026 1. UnitedHealthcare to drop prior authorization requirements for 1,700 services Full story 2. Massachusetts Medicare Advantage insurer hit with another enrollment…

DOJ ups MA fraud crackdown | Centene names CIO | Wis. payer goes on M&A offense | Labor Dept. eyes assoc. health plan expansion | Fla. sues PBMs for alleged price fixing

Feds’ MA fraud crackdown continues + a regional Wis. payer details expansion plans August 31, 2026 1. DOJ steps up crackdown on Medicare Advantage upcoding Full story 2. ‘No-regret moves’: A regional Wisconsin insurer goes on the acquisition offense Full…

Md. sues UnitedHealth over Medicaid contract | Elevance loses bid for quick star ratings recalculation | Calif. legislature passes prior auth bill | Cigna ties cash benefits to medical claims | Medicare's GLP-1 program gains traction

Elevance denied a quick star ratings redo + UnitedHealth sued over Md. Medicaid issues August 28, 2026 1. Maryland sues UnitedHealth for $380M over Medicaid administration issues Full story 2. Federal court denies Elevance’s bid for emergency 2026 star ratings…

Stay current with Payer Issues.