Payer Issues Archives - Page 14 of 167 - Becker's Payer Issues

A split hospitals and payers now share | Aetna, Optum settle 'dummy code' lawsuit | BCBS Tenn. cuts more jobs | CVS sued over Wegovy decision | Alignment hires former AHIP CEO

September 8, 2025 1. Hospitals aren't the only ones stepping back from Medicare Advantage Full story 2. BCBS Tennessee cuts more jobs Full story 3. Healthcare needs AI that delivers. The 5 companies making it happen: here. 4. Aetna, Optum…

3 Medicare Advantage market exits | GOP lawmakers eye ACA subsidies extension | CMS' MA audit expansion hits a snag | Mass. to require vaccine coverage beyond CDC recs | Change hack delayed VA Oracle test

September 5, 2025 1. Elevance among latest insurers to pull back on Medicare Advantage Full story 2. GOP lawmakers file bill to extend enhanced ACA subsidies Full story 3. From GLP-1 costs to chronic care ROI: Hear what payer CFOs…

MA risk adjustment 'a failing system': Nonprofit insurers | CMS expands catastrophic coverage | Fla. Blue, Memorial split | Employers brace for 15-year-high health costs | 12 UnitedHealth updates

September 4, 2025 1. Medicare Advantage risk adjustment 'a failing system': Report Full story 2. CMS expands eligibility for catastrophic health plans Full story 3. Pressure to eliminate ghost networks is rising. See how payers are responding: here. 4. Florida Blue,…

UnitedHealthcare grows gold card program | Cigna selling 18 clinics | CMS updates AHEAD model | 7 new insurance leaders at health systems | 5 payer leaders' biggest wins in '25

September 3, 2025 1. UnitedHealthcare grows gold card program Full story 2. Biggest health plan wins in 2025 from 5 leaders Full story 3. Turn disconnected data into actionable intelligence. Get an inside look at BCBS plans' member-first strategies here.…

Cigna invests $3.5B in specialty pharmacy company | ACOs save $2.4B in '24 | MA reduces care costs in Calif: UCLA | NYC partners with UnitedHealth, EmblemHealth for benefits | 9 payers fined by states

September 2, 2025 1. Cigna invests $3.5B in former Walgreens specialty pharmacy subsidiary Full story 2. Medicare Advantage plans keep senior care costs down in California: UCLA study Full story 3. BCBS leaders: Streamline prior auth with AI-powered data strategies.…

UnitedHealth sues Radiology Partners | Medical groups push back on Cigna downcoding policy | CMS starts 'chili cook-off' to fight fraud | Senators probe Change hack loan collections | Federal PBM investigation grows

August 29, 2025 1. UnitedHealthcare sues Radiology Partners over No Surprises claims Full story 2. Medical associations push back on Cigna's new downcoding policy Full story 3. AI is moving payment integrity from automation to transformation—see how it’s reshaping accuracy…

No Surprises IDR process has cost $5B | NY payer reaches 'ghost network' settlement | CVS settles with Mass. over Medicaid drug prices | Aetna expanding claims reviews | Optum's 3 drugs to watch

August 28, 2025 1. No Surprises dispute process has cost $5B since 2022: Study Full story 2. Aetna expanding claims reviews in September Full story 3. BCBS leaders: Streamline prior auth with AI-powered data strategies. Details here. 4. New York…

DOJ widens UnitedHealth probe: Bloomberg | Blue Shield Calif. names CEO | Mass. payers to return $75M in rebates | Google inks prior auth partnership | Cigna, Ky. system to split

August 27, 2025 1. UnitedHealth criminal probe goes beyond Medicare: Report Full story 2. Blue Shield of California taps CEO Full story 3. Policy shifts are hitting benefits and budgets. Find Cigna's breakdown for execs here. 4. 5 Massachusetts insurers…

UnitedHealthcare, Johns Hopkins split | Payer mix in the largest for-profit health systems | Select Health CEO details MA strategy in '26 | Presbyterian names insurance president | Colo. moves to offset rising ACA costs

August 26, 2025 1. Johns Hopkins goes out of network with UnitedHealthcare Full story 2. Payer mix in the largest for-profit health systems Full story 3. AI is moving payment integrity from automation to transformation—see how it’s reshaping accuracy and…

Judge pauses parts of ACA rule | MA plan, DOJ settle over fraud scheme | Jefferson Health Plans posts $170M loss | Ohio system to stop accepting out-of-network patients | GLP-1s linked to lower cancer risk

August 25, 2025 1. Judge pauses parts of new ACA 'integrity' rule Full story 2. North Carolina Medicare Advantage plan settles with DOJ over identity theft scheme Full story 3. How Aetna Medicare is rethinking oncology strategy here. 4. Jefferson Health…