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

UnitedHealthcare sues Idaho over MA actions | Lessons payer execs will bring into '26 | Humana to appeal MA star ratings loss | Hospitals prep for all ACA subsidy scenarios | CMS to cut 15 drug prices in '27

UnitedHealthcare says Idaho overstepped with MA regulations and Humana is appealing its star ratings November 28, 2025 1. UnitedHealthcare sues Idaho insurance director over Medicare Advantage commission crackdown Full story 2. What lessons health plan leaders will bring into 2026…

CMS pitches star ratings overhaul | Payers prep amid ACA uncertainty | What's behind all the industry 'affiliations' | Where ACA benchmark premiums are rising most in '26 | Contigo to close

CMS has published its ’27 MA proposed rule and payers are prepping for all ACA subsidy scenarios November 26, 2025 1. CMS pitches star ratings reform in 2027 Medicare Advantage proposed rule: 7 notes Full story 2. How payers are…

Trump delays ACA subsidy pitch | HHS appeals ruling against MA audit rule | UnitedHealth buys $46M Nev. medical center | 1:1 with HMSA's new president | Optum Rx removes more drug reauthorizations

Trump delays an ACA subsidy proposal and UnitedHealth makes a big purchase in Nevada November 25, 2025 1. HHS appeals decision that struck down Medicare Advantage audit final rule Full story 2. Trump delays 2-year ACA subsidy extension proposal: Report Full story 3.…

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…