Payer Issues Archives - Page 2 of 161 - Becker's Payer Issues

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…

No ACA subsidy extension in Senate funding deal | What payers focused on in Q3 | BCBS sues over trademark use | Johns Hopkins convening insurers on quality metrics | Payers fined in 2025

No ACA subsidy extension + payers’ key areas of focus in Q3 November 10, 2025 1. Payers talk margin recovery, product pullbacks and PBM transformation in Q3 Full story 2. Senate advances potential funding deal sans ACA subsidy extension: 5…

Payers post Q3 profits | Cambia, BCBS Ark. to affiliate | CMS pilot targets Medicaid drug costs | Health insurance 'not meant to be sexy': CEO | 2 health systems launch ACA plan

Payers report Q3 profits, Cambia, BCBS Ark. affiliate, CMS launching Medicaid drug cost pilot November 7, 2025 1. Payers ranked by Q3 profits Full story 2. Cambia, BCBS Arkansas announce strategic affiliation Full story 3. This VBC-aligned autism model expands…

Anthem, Northern Light reach agreement | The Cigna Group's new CMO | Americans like their health plans, but half are skeptical of the system | UnitedHealthcare, PacificSource face cease and desists | NC's new small business health plan

Anthem and Northern Light’s new contract, plus N.C.’s plan for small employers November 6, 2025 1. Anthem, Northern Light ink agreement Full story 2. The Cigna Group names chief medical officer Full story 3. 'Things don't have to stay the…