Payer Issues Archives - Page 16 of 164 - Becker's Payer Issues

Payers to ease prior auths | NYC reverses course on Aetna MA plan | CMS finalizes ACA integrity rule, raises MA commission caps | Trump’s approach to PBMs | 12 drugs in shortage

June 23, 2025 1. Payers to reduce prior authorizations Full story 2. CMS finalizes rule to improve ACA marketplace integrity, lower premiums Full story 3. What's next for value-based care? Aetna, Emblem & BCBS are scaling smarter models — learn…

Medicaid top of mind for payer execs | Court greenlights NYC's Aetna MA plan | Optum West CEO departs | MA enrollees see fewer home health visits: MedPAC | 4 GLP-1 updates

June 20, 2025 1. Medicaid top of mind for payer execs: 15 leaders' biggest priorities Full story 2. State high court greenlights New York City's $15B Aetna Medicare Advantage plan Full story 3. The AI agent advantage is real — and…

Tariffs threaten to raise premiums | Judge OKs class-action against BCBS Mont. | MA architect: The system is being abused | More payers seek higher ACA rates | Walmart launches MA, Medicaid wellness program

June 19, 2025 1. Tariff threats contribute to rising premiums: 3 things to know Full story 2. Why an architect of Medicare Advantage says the 'system is being abused' Full story 3. $57.7B lost to avoidable readmits. How LTACHs are cutting risk…

Former MA exec acquitted | Payers face 'deteriorating' outlook: Fitch | Lawmakers pitch Medicare public option | ICHRA growth surges | Judge approves UnitedHealth 401(k) settlement

June 18, 2025 1. Former Medicare Advantage exec acquitted on fraud charges Full story 2. GOP budget bill leaves payers with 'deteriorating' outlook: Fitch Full story 3. BCBS, Cigna & Humana are rethinking cost, access and experience. Their game plan —…

UnitedHealth cuts some MA commissions | Senate GOP floats steeper Medicaid cuts | Ochsner Health Plan CEO heads to Aetna | Viewpoint: MA execs should enroll in their plans | Humana CEO details 5-year plan

June 17, 2025 1. UnitedHealth cuts some Medicare Advantage broker commissions Full story 2. Humana's path forward as a consumer healthcare company: 5 things to know Full story 3. A 4-step roadmap to modernizing prior auth — get the guide…

CMS shares Medicaid data with immigration officials | UNC sues Aetna, Humana over 340B payments | Mercy, Humana open joint clinics | How Congress gets health coverage | 'Payer scorecards' pay dividends to hospitals

June 16, 2025 1. CMS ordered to provide Medicaid data to immigration officials: Report Full story 2. UNC Health sues Aetna, Humana for alleged 340B drug underpayments Full story 3. Medicare Advantage, AI: What's really shaping payer strategy in 2025?…

Humana's CMO details ambient AI pilot | Former UnitedHealth employees drop WARN violation claims | 6 payers recently fined | The Trump admin's approach to MA | Cigna adds new AI tools

June 13, 2025 1. Humana's top physician details ambient AI pilot: 5 notes Full story 2. Former UnitedHealth employees drop claims alleging WARN Act violations Full story 3. New chronic wound research could shift coverage policies. What payers should know…

Layoffs at BCBS Mich. | Lawmakers backtrack on MA reforms | Blue Shield Calif., U of Calif. Health face split | Ill. physician sentenced for billing fraud | Iowa enacts PBM law

June 12, 2025 1. BCBS Michigan lays off 220 Full story 2. Lawmakers backtrack on Medicare Advantage changes in budget bill Full story 3. Experts talk proven UM strategies to boost member outcomes & trust. Join them, here. 4. Blue…

CVS, Cigna settle exec noncompete case | Moody’s downgrades UnitedHealth | Payers oppose MA changes in GOP budget bill | Growth slows for BCBS plans | Ga. system backs ICHRA startup

June 11, 2025 1. CVS settles with Cigna in executive noncompete case Full story 2. Moody's downgrades UnitedHealth's outlook to negative, affirms credit ratings Full story 3. What's next for value-based care? Payer execs talk strategy for future success here. 4. Insurers…

Molina lays off 250+ | Lawmakers: Expand UnitedHealth probe | Aetna subsidiary received $7M in MA overpayments: OIG | Ore. enacts corporate physician limits | Cigna, Allegheny Health Network face split

June 10, 2025 1. Molina lays off 250+ after contract loss Full story 2. Ocasio-Cortez calls for expanded UnitedHealth investigation after nursing home report Full story 3. DRG claim review uncovered $95K in overpayments on a $440K heart procedure due…