Payer Issues Archives - Becker's Payer Issues

Centene headcount falls 12% | Senators probe insurers over ACA plan terminations | Ghost network crackdown intensifies | Humana cuts jobs | Kaiser changes trigger MA special enrollment in Nev.

Centene posts $71M Q3 loss + Lawmakers eye insurers’ role in ACA plan cuts October 27, 2026 1. Centene loses 12% of employees since end of 2025 Full story 2. Senators probe 10 insurers over role in terminating ACA coverage…

Big employers sue UnitedHealth | Centene challenges '27 MA star ratings | Uninsured rate backslide evokes pre-ACA era | CMS to tighten ACA subsidy eligibility verification | More AI, consumerism lead '27 industry predictions

Centene is the latest to challenge MA star ratings + Large employers sue UnitedHealth over claims October 26, 2026 1. ‘Back to the Future’: Uninsured rate backslide stirs pre-ACA comparisons Full story 2. Kraft Heinz, Ralph Lauren among large employers…

Optum looks to get Md. Medicaid lawsuit tossed | Elevance's site-of-care policy put hospitals on alert | DOJ charges 15 in $2B fraud cases | House bill targets MA star ratings calculations | 4 payers exiting Medicaid markets

Plus: Why an Idaho health system is jumping into MA as other providers run out October 23, 2026 1. ‘A story that it knows is untrue’: Optum moves to get Maryland’s Medicaid lawsuit tossed Full story 2. Elevance’s new site-of-care…

Horizon to buy Summit Health's NJ assets | 'Second blue bid' boosts Elevance | Self-insured employers back prior auth reform | Uninsured rate hits 11% | PacificSource cuts more jobs

Plus: a closer look at payers’ ACA footprints in ’27 October 22, 2026 1. Horizon BCBS to acquire Summit Health’s New Jersey business Full story 2. ‘The market is reaping the benefits’ of the BCBS antitrust settlement, Elevance says Full story…

Elevance boosts earnings outlook | Mich. system launches health plan | CMS freezes more Medi-Cal funds | NY insurer sues over '27 MA star rating | 6 healthcare fights on the ballot

Plus: Experts detail the 3 most feasible MA reforms October 21, 2026 1. Elevance reports $1.4B in Q3 profit, names Carelon president Full story 2. New York payer says 2027 Medicare Advantage star rating will cost it $380M Full story…

18 payers exiting MA | UHC names marketing lead | Centene to exit Hawaii Medicaid | CMS lifts enrollment freeze on Mass. payer | 10 recent billing fraud cases

Plus: A Medicare broker faces possible Nasdaq delisting October 20, 2026 1. 18 payers exiting Medicare Advantage in 2027 Full story 2. Centene to leave Hawaii Medicaid program Full story 3. Risk adjustment without the annual scramble: See why perspectives from…

UnitedHealth grows subsidiary count | CMS proposal targets MA ghost networks, PBMs | Md. payer lays off 161 | Minn. might claw back Medicaid funds | Software owner sentenced in $1B Medicare fraud scheme

Plus: CVS’ Oak Street Health gets new chief medical officer October 19, 2026 1. UnitedHealth’s subsidiary count gets bigger Full story 2. CMS proposes public scores for Medicare Advantage provider directories, flat-fee limits for PBMs Full story 3. Deploying AI…

5 best MA insurers of 2027: US News | Agents, brokers sue CMS over ACA registration freeze | A look at Optum's financials | UnitedHealth taps marketing chief | Mark Cuban teams up with Epic, Amazon on Rx price tool

Plus: Centene expands CHOICE to more employees October 16, 2026 1. The best Medicare Advantage companies for 2027: US News Full story 2. Agent, broker group sues CMS to block ACA registration freeze Full story 3. Becker’s Fall Payer Issues…

CMS reverses some of its 760,000 ACA cancellations | Cigna sued over ground ambulance payments | ACA subsidy verification rule proposed | 8 notes on MA star ratings | 31 payer exec moves

Plus: Insurers collaborate to improve provider directory data October 15, 2026 1. CMS reinstates some ACA enrollees after cutting 760,000 people Full story 2. IRS, Treasury pitch ACA subsidy verification rule: 7 things to know Full story 3. Everything you…

Optum Health's turnaround accelerates | ACA subsidies wiped for 189,000 duplicate, deceased enrollees | UnitedHealthcare's arbitration awards burden | CMS can bar providers from Medicare, Medicaid | CVS' $315M opioid settlement

Plus: Walmart makes some GLP-1s free for employees October 14, 2026 1. Optum Health’s turnaround picks up speed Full story 2. CMS ends ACA subsidies for 189,000 duplicate or deceased enrollees: 5 notes Full story 3. ACA volatility demands precision.…

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