Payer Issues Archives - Page 18 of 177 - Becker's Payer Issues

Trump eyes ACA subsidy extension | Payer seeks hospital probe over No Surprises dispute | CMS ups hospital outpatient rates 2.6% | Blue Shield Calif., Magellan sued over 'ghost networks' | Inside year 1 of EmblemHealth's diabetes program

Trump to pitch ACA subsidy extension and CMS expands site-neutral payments November 24, 2025 1. Trump to propose 2-year ACA subsidy extension with eligibility limits: Reports Full story 2. CMS ups hospital outpatient rates 2.6%, expands site-neutral payments in 2026:…

Lawmakers file wave of MA bills | Independent Health, MVP bet on transparent PBM | Lilly to launch employer GLP-1 model | Ore. flags 3 payers over high costs | 5 new drug shortages

Democrats set their sights on Medicare Advantage reform and Lilly’s direct-to-employer GLP-1 model November 21, 2025 1. Democratic lawmakers target Medicare Advantage in wave of bills Full story 2. Oregon flags 3 payers over 'unreasonable' surge in healthcare costs Full story…

Cheaper GLP-1s signal a coverage shift | What MA enrollees think about supplemental benefits | Centene's Medicare CEO talks D-SNP access | 10 healthcare AI themes for '26 | 10 UnitedHealth updates

Cheaper GLP-1s could shift coverage policies and Centene is doubling down on D-SNP access November 20, 2025 1. Could cheaper GLP-1s signal a shift in payer policies? Full story 2. 'Passionate about making it better': Centene's Medicare CEO on expanding…

More regional payer M&A | Centene moves some employees to ICHRA | Oak Street to cut 200+ jobs | Former FDA commissioner joins UnitedHealth board | Jefferson health plan posts $44M loss

Regional payer M&A activity continues and Centene walks the talk on ICHRA November 19, 2025 1. Independent Health to join MVP Health Care Full story 2. Why Centene is moving some employees to ICHRA Full story 3. Real-time DME workflows…

UCare to shut down | UnitedHealth leans on AI to drive growth | 2 convicted in $233M ACA fraud scheme | Aetna launches AI navigation tool | Epic, Humana partner

Payers dive deeper into AI and UCare plans to wind down operations November 18, 2025 Today's newsletter tracks how AI is reshaping payer operations, with UnitedHealth leaning on automation to drive growth while Aetna embeds generative AI throughout its member…

Horizon BCBS settles fraud allegations for $100M | Optum Health names CEO | Republicans weigh sending ACA dollars to consumers | Ind. payer lays off 238 | Aetna delays Medicare inpatient pay policy

A BCBS fraud settlement is reached and Optum Health gets a new leader November 17, 2025 1. Horizon BCBS New Jersey to pay $100M over false claims allegations Full story 2. Optum Health names CEO Full story 3. 5 AI…

UnitedHealth eyes Optum finance growth | States decry restricted MA access | Medicaid spending trends: 4 notes | 30 most consistent health IT vendors | 6 prior auth updates

UnitedHealth eyes Optum finance growth and states warn about MA broker cuts November 14, 2025 1. 'A very attractive margin business': UnitedHealth eyes growth for Optum's finance unit Full story 2. States warn payers not to restrict Medicare Advantage access…

Humana sues ChenMed | Evernorth cutting jobs in Ariz. | Shutdown ends with no ACA subsidy deal | Ind. drops payer from Medicaid program | Elevance fights to keep NYC contract

Humana sues a joint venture partner and the government reopens without a subsidy deal November 13, 2025 1. Humana claims ChenMed skimmed 'tens of millions' from JenCare joint venture Full story 2. Cigna to cut 143 jobs amid clinic deal with…

Trump floats sending ACA dollars to consumers | CMS selects Medicare prior auth pilot vendors | Medicaid profits to hit low point in '26: Elevance | UnitedHealthcare to end most remote monitoring coverage | Lilly drops CVS for employee drug benefits

Trump suggests redirecting ACA funds and Elevance predicts Medicaid low point November 12, 2025 1. Trump blasts insurers amid ACA subsidy talks Full story 2. Medicaid margins to hit low point in 2026, Elevance CFO says Full story 3. This…

UnitedHealth's plan to 'restore swagger' | House bill targets Medicare prior auth pilot | Priority Health names president | Cigna's generics pricing questioned | 10 big trends for payer execs headed into '26

UnitedHealth aims to ‘restore swagger’ and House Dems look to axe Medicare prior auth pilot November 11, 2025 1. UnitedHealth's new CFO details plan to 'restore swagger' Full story 2. House Democrats introduce legislation to kill Medicare prior authorization pilot Full…