Payer Issues Archives - Page 19 of 161 - Becker's Payer Issues

Optum cuts more prior auth | Cigna, HCSC close MA deal | Molina's highest-paid execs | Kaiser's Risant names 3 leaders | 7 MA updates

March 19, 2025 BHR Newsletter 1. Optum to eliminate prior authorization for 80 drugs Full story 2. Cigna, HCSC close $3.3B Medicare Advantage sale Full story 3. Molina's 5 highest-paid executives in 2024 Full story 4. NCQA credentialing changes are coming…

JPMorgan sued over CVS relations | Optum staff in NY vote to unionize | Calif. bans 2 "sham" health plans | Work rules may strip 5M of Medicaid: Report | 2 most innovative payers

March 18, 2025 BHR Newsletter 1. JPMorgan sued by employees over PBM relationship with CVS Full story 2. California bans "sham" health plans, reaches $1.3M settlement Full story 3. Optum staff in New York vote to unionize Full story 4. Don't…

Cigna's highest-paid execs | CMS doubles down on Medicare drug negotiations | Nev. to award Medicaid contracts | Dr. Oz's Senate hearing: 6 takeaways | Idaho passes Medicaid reform bill

March 17, 2025 BHR Newsletter 1. Cigna's 5 highest-paid executives Full story 2. Nevada to award Medicaid contracts Full story 3. CMS doubles down on Medicare drug price negotiations Full story 4. Faster, smarter data management is within reach — how…

$84B in MA overpayments in '25: MedPAC | Highmark insurance business reports $166M loss | 3 payers among most ethical companies | 10 payers recently fined | 10 possible blockbuster drugs in '26

March 14, 2025 BHR Newsletter 1. MedPAC estimates $84B in Medicare Advantage overpayments in 2025: 10 notes Full story 2. Highmark Health Plans reports $166M loss, cites GLP-1s as headwind Full story 3. 10 payers recently fined by states Full…

Cigna shuffles C-suite | BCBS Mass. latest to sue over star ratings | CMS to end 4 Medicare payment models | NM bill eyes medical marijuana coverage | Humana plans $20M HQ renovation

March 13, 2025 BHR Newsletter 1. Cigna names COO, CFO in executive shuffle Full story 2. BCBS Massachusetts latest to sue CMS over Medicare Advantage star ratings Full story 3. CMS to end 4 Medicare payment programs early Full story…

Blue Shield of Calif. CEO exits | Molina pays $40M to settle alleged Medicaid violations | NC insurer to close | Minn. bill would require GLP-1 coverage | 10 recent billing fraud cases

March 12, 2025 BHR Newsletter 1. Blue Shield of California CEO exits after 2 months Full story 2. Molina pays $40M to settle alleged Medicaid violations in whistleblower lawsuit Full story 3. North Carolina insurer to wind down operations Full…

A change 'key to your future existence as a health plan' | CMS pitches ACA changes: 5 notes | Ill. awards D-SNP contracts | Breaking down Trump's price transparency order | Medicaid cuts could cost hospitals $80B

March 11, 2025 BHR Newsletter 1. The pharmacy change 'key to your future existence as a health plan' Full story 2. CMS pitches shortening ACA enrollment period: 5 things to know Full story 3. Illinois awards 4 D-SNP contracts Full…

6 Blues reporting losses | Humana's highest-paid execs | HHS offers buyouts to all employees | Medicare insurers with best mobile apps | 13 payers cutting jobs

March 10, 2025 BHR Newsletter 1. Humana's highest-paid executives in 2024 Full story 2. 6 BCBS plans reporting losses Full story 3. 13 payers cutting jobs Full story 4. AI is driving real results for providers and payers. See how it's transforming healthcare efficiency and…

More Blues restructuring | Humana, Novo Nordisk partner | CareFirst sues Change Healthcare over cyberattack | Fitch downgrades UPMC after insurance losses | 5 federal healthcare updates

March 7, 2025 BHR Newsletter 1. BCBS North Carolina restructures, launches new parent company Full story 2. Humana, Novo Nordisk partner on Wegovy subscription service Full story 3. CareFirst BCBS sues Change Healthcare over cyberattack Full story 4. Better workplace…

Dozens of health systems sue BCBS | GOP must cut Medicaid to hit budget goals: CBO | Healthcare job losses by state if ACA credits end | Kaiser plans more layoffs | Envision taps board chair

March 6, 2025 BHR Newsletter 1. Dozens of health systems file 'opt-out' antitrust lawsuits against Blue Cross Blue Shield Full story 2. Medicaid cuts must occur to meet GOP budget goals: CBO Full story 3. Envision Healthcare taps new board…