Payer Issues Archives - Page 12 of 179 - Becker's Payer Issues

CMS rolls out new pediatric care model | Is MA working? | Highmark's $674M operating loss | 34 healthcare orgs make Fortune's 'most innovative' list | Minn. Medicaid corrective action plan gets greenlight

CMS introduces pediatric care model and approves Minnesota’s corrective action plan for Medicaid March 25, 2026 1. CMS unveils new pediatric care model Full story 2. The Medicare Advantage paradox: Who benefits most? Full story 3. Medicaid's new era: Humana,…

Humana, CommonSpirit reach MA agreement | BCBS Minn. CEO exits Sutter board | 4 exec appointments | Bill seeks Medicare cuts for PE-owned facilities | 20 best small cities for careers

Humana and CommonSpirit wrap monthslong negotiations, and Cigna Healthcare appoints CMO March 24, 2026 1. Humana, CommonSpirit reach 3-year MA agreement, including Colorado and Texas Full story 2. BCBS Minnesota CEO leaves Sutter board over Allina deal Full story 3.…

CMS to phase out fax, mail | A surge in MA special needs plans | 5 ACA updates | Regence BCBS, Legacy Health face contract split | Conn.'s pitch for a $200M health trust fund

The ACA has its 16th anniversary, and MA SNPs gain traction March 23, 2026 1. 'The 1980s called': CMS finalizes rule to phase out fax, mail Full story 2. The explosion of the Medicare Advantage special needs plan Full story…

Senate Dems pitch health insurance reforms | Providence weighs health plan sale | 9% of ACA enrollees drop coverage over costs: KFF | Humana faces lawsuit over employee tobacco surcharges | HHS probes abortion coverage in 13 states

Senate Democrats eye health insurance reforms, while HHS targets abortion coverage March 20, 2026 1. Senate Democrats lay out health insurance reform agenda — and put industry on notice Full story 2. Providence explores sale of health plan Full story…

Optum Health's new CEO charts a reset | Dr. Oz targets Fla. Medicaid | BCBS Ala. received $7M in MA overpayments: OIG | Elevance names DC Medicaid leader | Pa. opens special MA enrollment period

Optum Health’s CEO talks new strategy and CMS expands its Medicaid fraud crackdown March 19, 2026 1. What comes next for Optum's care delivery business, per its CEO Full story 2. Dr. Oz sets sights on Florida amid widening Medicaid…

2 Calif. payers cutting jobs | Highmark, BCBS Kansas City cleared for affiliation | Anthem Indiana's new leader talks designated network strategy | Payers, hospitals decry CMS' non-network plan pitch | 3 GLP-1 updates

Another Blues affiliation moves forward and payers join forces with hospitals against CMS pitch March 18, 2026 1. 11 payers cutting jobs Full story 2. Highmark-BCBS Kansas City affiliation green-lit by Missouri regulators Full story 3. AI is redefining payment integrity.…

Exec pay falls at Cigna, Molina | UnitedHealthcare expands doula benefits | BCBS Ill. tightens E/M billing | Mount Sinai reaches for mic amid Anthem split | Top 25 pharmacies by revenue

Executive pay falls at Cigna + Molina and UnitedHealthcare goes big on doula coverage March 17, 2026 1. Cigna's 5 highest-paid executives in 2025 Full story 2. Mount Sinai reaches for the mic amid Anthem dispute fallout Full story 3.…

BCBS study ties AI-driven coding to rising costs | CMS to launch IDR platform | Best MA provider search tools | Minn. seeks full access to Optum Medicaid report | MA enrollment diversifies: 4 notes

New BCBS data links hospital AI to rising costs and CMS says it will launch a new IDR platform March 16, 2026 1. BCBS study: Hospital AI billing tools may be driving up healthcare costs by billions Full story 2.…

Many MA pay rate comments tied to 'dark money' | 2 states inch closer to Medicaid work rules | Court rules against Aetna in gender-affirming care case | Ill. bill takes aim at AI-driven downcoding | MA spending 14% higher than FFS: MedPAC

Many notes on MA pay rate tied to ‘dark money’ and states are inching closer to Medicaid work rules March 13, 2026 1. About 82% of public Medicare Advantage rate notice comments tied to 'dark money' group: KFF Full story…

UnitedHealth must release docs in AI denials case | NC state plan won't extend Aetna contract | MA overpayments causing Medicare costs to rise: Report | Largest MCOs by enrollment | 10 providers seeking payer talent

UnitedHealth has to hand over docs in AI denials case and NC may drop Aetna after one contract cycle March 12, 2026 1. Judge orders UnitedHealth to hand over documents in AI coverage denial case Full story 2. NC State…