October 8, 2025 1. California bill eliminating 'redundant' prior authorization barriers signed into law Full story 2. Why personal relationships among executives matter in payer-provider contract negotiations Full story 3. The 5 AI disruptors every healthcare exec should know: here. 4.…
Payer Issues
October 7, 2025 1. UnitedHealthcare calls out healthcare groups' 'cynical' contract negotiation strategy Full story 2. 7 insurers fully exiting Medicare Advantage Full story 3. Navigating Payer Compliance with CERIS’s Cereasa Horner — insights on AI, oversight challenges, and strategies to stay…
October 6, 2025 1. UnitedHealth shareholder proposes separating CEO, board chair roles Full story 2. Big MA market exits are not fazing all insurers Full story 3. This VBC-aligned autism model expands access — without more provider hours. See how…
October 3, 2025 1. UnitedHealth Group taps AI chief Full story 2. Blue Cross North Carolina offers employee buyouts Full story 3. Even de-identified data isn't safe. The hidden AI privacy risk leaders need to know — here. 4. 20%…
October 2, 2025 1. Cigna debuts controversial downcoding policy; on hold for California HMO plans Full story 2. UnitedHealthcare cut to CRNA services goes into effect Full story 3. New case study: LTACHs cut sepsis readmissions — and payer costs. See the…
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October 1, 2025 1. Insurers launch 2026 Medicare Advantage plans Full story 2. Court orders Humana to pay $32M in fees following False Claims settlement Full story 3. 40% of your members skip preventive care—and it costs you $20 million+. See…
September 30, 2025 1. Where ACA enhanced subsidies stand: 7 updates Full story 2. 30 health systems dropping Medicare Advantage plans Full story 3. CMS ramping up audits in MA and Medicaid. Is your plan ready? Find out here. 4.…
September 29, 2025 1. UnitedHealth asks judge to toss lawsuit from California pension fund Full story 2. CMS expects Medicare Advantage enrollment to dip in 2026 Full story 3. Fix claim errors before they happen—real-time data exchange boosts accuracy and…
September 26, 2025 1. Judge sides with Humana, tosses Medicare Advantage audit rule Full story 2. Most regional payers are operating at a loss: 5 notes Full story 3. How Cigna, Humana + others are adapting to Medicare Advantage volatility…
September 25, 2025 1. Health Care Service Corp. is playing the long game in Medicare Advantage Full story 2. UnitedHealthcare to pay $359M in rebates Full story 3. Shared mobile device use is rising fast — and so are risks.…