Payer Issues Archives - Page 14 of 164 - Becker's Payer Issues

Humana speeds up prior auth reforms | Oscar cuts earnings outlook | Ohio system reduces ACA offerings | UnitedHealthcare division CEO departs | HHS to probe 'misleading' MA marketing

July 22, 2025 1. Humana to cut prior auth requirements, introduce gold card program Full story 2. Oscar Health is latest insurer to cut earnings guidance Full story 3. Avoid costly rip-and-replace projects — meet CMS mandates with existing tech…

Aetna dragged into Mangione trial | Judge tosses Humana's star ratings challenge | More layoffs at Blue Shield Calif. | CMS to share Medicaid data with ICE | Insurers request major ACA rate hikes

July 21, 2025 1. Luigi Mangione's attorneys say prosecutors wrongfully received medical records from Aetna Full story 2. Blue Shield of California to conduct another round of layoffs Full story 3. Join leaders at Becker's Payer Issues Roundtable + share…

21 states challenge new ACA rule | Medicaid cuts tied to 1,000 more deaths annually | Employers to shift costs in '26 | How a payer uses AI against heat waves | 10 UnitedHealth updates

July 18, 2025 1. 21 states sue CMS over new ACA restrictions Full story 2. How 1 payer is using AI to counter heat waves Full story 3. Build real-time interoperability and compliance now. Playbook here. 4. 1,000+ additional deaths,…

Elevance cuts outlook | UnitedHealth made up of 2,694 subsidiaries | Humana partners with MyChart | Who's gaining, losing ACA members? | 10 recent billing fraud cases

July 17, 2025 1. Elevance Health cuts 2025 earnings guidance Full story 2. UnitedHealth is composed of nearly 2,700 subsidiaries: 10 notes Full story 3. Your feedback at Becker's Payer Issues Roundtable — we want to hear it. Apply to…

UnitedHealth's quiet move to boost margins | Geisinger Health Plan cuts jobs | CalPERS swaps Optum for CVS | Calif. targets insurance fraud scheme | HHS layoffs resume

July 16, 2025 1. Geisinger to cut jobs from health insurance division Full story 2. UnitedHealth quietly sold assets to improve margins: Bloomberg Full story 3. Close care gaps faster with EHR-integrated alerts. Get next steps: here. 4. California issues…

GOP eyes deeper cuts to Medicaid, Medicare | The state of MA market consolidation | AdventHealth hospital sues BCBS plan | Highmark names WV leader | 22 payers cutting jobs

July 15, 2025 1. House GOP eyes deeper Medicaid, Medicare cuts in next budget bill: Bloomberg Full story 2. Medicare Advantage market consolidation: 5 things to know Full story 3. Medical transport brokers can hinder care access. Payers are going in-house…

Another BCBS plan offers employee buyouts | UnitedHealth targets critics | An impending one-two punch on employer healthcare costs | 4 new CEOs at UnitedHealthcare | 7 MA updates

July 14, 2025 1. UnitedHealth cites CEO's killing in moves to stymie criticism: NYT Full story 2. Independence Blue Cross offers employee buyouts Full story 3. What's next for value-based care? Aetna, Emblem & BCBS are scaling smarter models —…

BCBS La. loses star ratings lawsuit | How UnitedHealthcare is rethinking diabetes care | Humana names digital leader | Where payers own the most primary care | NJ state plan facing major rate hikes

July 11, 2025 1. How UnitedHealthcare is rethinking diabetes care in the GLP-1 era Full story 2. BCBS Louisiana loses Medicare Advantage star ratings lawsuit Full story 3. Joint care planning is no longer optional in VBC. See what works…

UnitedHealth names Medicaid CEO | BCBS sues 'fake' health plan | Payers' slice of primary care grows | UCare scales back | Trump eyes 200% tariffs on pharma

July 10, 2025 1. UnitedHealth Group names new Medicaid CEO Full story 2. Elevance, BCBS Association allege firm sold 'fake employee benefits' using their branding Full story 3. Double-digit HEDIS gains. How Healthfirst & InterSystems used real-time data to improve care…

DOJ probes former UnitedHealth employees | CVS to pay $949M in fraud penalties | NY payer president departs | Alignment wins star ratings lawsuit | Insurers' ACA risk payments hit $10.4B

July 9, 2025 1. WSJ: Former UnitedHealth employees questioned in DOJ investigation Full story 2. CVS' Omnicare hit with $949M penalty in False Claims case Full story 3. BCBS, Cigna & Humana are rethinking cost, access and experience. Their game plan —…