Payer Issues Archives - Page 16 of 177 - Becker's Payer Issues

Aetna to settle LGBTQ+ fertility lawsuit | Bankrupt hospital sues BCBS of Ala. | Faith-based investors press UnitedHealth for acquisition report | BCBS of Vt. calls out hospital costs | 19 payer CEO moves

Aetna to settle a lawsuit over fertility treatments, and BCBS of Alabama also hit with legal action December 23, 2025 1. Aetna to settle discrimination lawsuit over fertility treatments Full story 2. Hospital sues BCBS of Alabama over reimbursement amid…

UnitedHealth's audit: 10 notes | CMS pitches 2 Medicare drug-pricing models | Rural health funding office created | Will '26 be ICHRA's year? | 19 payer M&A deals

UnitedHealth shares companywide audit findings, and CMS' Medicare drug-pricing models December 22, 2025 1. UnitedHealth releases companywide policy audit report: 10 things to know Full story 2. CMS proposes 2 Medicare drug-pricing models Full story 3. Autonomous & proactive —…

Hospitals to Elevance: Drop 10% penalty policy | CMS debuts LEAD model | Minn. takes control of UCare | Humana received $10.5M in MA overpayments: OIG | More GLP-1s aim to enter market

Hospitals want Elevance to drop its new out-of-network penalty policy and CMS rolls out a new ACO mo December 19, 2025 1. Hospital groups call on Elevance to rescind 'punitive' 10% hospital penalty for using out-of-network providers Full story 2. CMS' long-term…

UnitedHealthcare delays RPM policy | Payer CEO eyes a future without prior auths | Petition to force vote on ACA subsidies | Humana CEO elected AHIP chair | What 5 Optum execs told us this year

UnitedHealthcare is delaying a controversial RPM coverage policy and there may be a vote on extendin December 18, 2025 1. UnitedHealthcare delays new remote physiologic monitoring coverage policy Full story 2. 'What if we could eliminate prior authorizations?': Why this…

ACA subsidies face expiration as House vote stalls | Calif. fines 3 Centene plans | 97% of insurance markets are highly concentrated: AMA | Payers ranked by price transparency compliance | 14 AI moves in '25

The House won’t be voting on extending ACA subsidies and a new report shows wide variation in price December 17, 2025 1. House GOP won't call vote on ACA subsidy extension Full story 2. California fines 3 Centene health plans…

Humana insurance president retiring | Highest-quality health plans in Calif. | Payers losing half of medical review cases: Study | NH bill targets AI-driven claims audits | Highmark posts $69M loss through Q3

Humana’s insurance leader is retiring and New Hampshire steps into the payer-provider AI fight December 16, 2025 1. Humana insurance president to retire, replacement named Full story 2. Health plans losing nearly half of cases that reach independent medical review:…

House GOP pitches healthcare bill | Insurers fall short on price transparency: Study | UCare cuts 250 jobs | CVS settles Okla. PBM case | 10 largest insurers

GOP lawmakers pitch another healthcare bill and a new study calls payers' price transparency complia December 15, 2025 1. House floats new healthcare bill after Senate proposals fail Full story 2. Insurers not fully complying with price transparency rules: Study…

ACA enhanced subsidies headed for cliff | Highmark, BCBS Kansas City to affiliate | CMS launches lifestyle medicine Medicare pilot | Healthiest states for women, children: UnitedHealth | Best hospitals for maternity care

No solution reached for expiring ACA subsidies and BCBS consolidation continues December 12, 2025 1. Competing bills tackling ACA subsidies fail in Senate Full story 2. Highmark, BCBS Kansas City to affiliate Full story 3. What's helping pharmacies meet payer…

ACA enrollment is up — so far | La. cuts UnitedHealth Medicaid contract | Judge clears new NYC employee health plan | BCBS Texas, Ascension Texas face split | Medicaid work rules are coming: 8 things to know

ACA enrollment hasn’t slowed down and insurers are prepping for Medicaid work rules December 11, 2025 1. ACA enrollment tracking ahead of last year: 6 notes Full story 2. Louisiana cuts UnitedHealthcare Medicaid contract, affecting 330,000 enrollees Full story 3.…

GOP moves toward ACA subsidy expiration | WV sues Optum over opioid crisis | Minn. petitions for UCare takeover | 7 key payer reimbursement updates | CVS raises '25 outlook

Republicans aren’t pitching an ACA subsidy extension and Optum is accused of worsening the opioid cr December 10, 2025 1. GOP prepares vote on competing bill addressing ACA subsidy expiration Full story 2. West Virginia sues Optum over opioid crisis Full story…