Payer Issues Archives - Page 24 of 177 - Becker's Payer Issues

No Surprises IDR process has cost $5B | NY payer reaches 'ghost network' settlement | CVS settles with Mass. over Medicaid drug prices | Aetna expanding claims reviews | Optum's 3 drugs to watch

August 28, 2025 1. No Surprises dispute process has cost $5B since 2022: Study Full story 2. Aetna expanding claims reviews in September Full story 3. BCBS leaders: Streamline prior auth with AI-powered data strategies. Details here. 4. New York…

DOJ widens UnitedHealth probe: Bloomberg | Blue Shield Calif. names CEO | Mass. payers to return $75M in rebates | Google inks prior auth partnership | Cigna, Ky. system to split

August 27, 2025 1. UnitedHealth criminal probe goes beyond Medicare: Report Full story 2. Blue Shield of California taps CEO Full story 3. Policy shifts are hitting benefits and budgets. Find Cigna's breakdown for execs here. 4. 5 Massachusetts insurers…

UnitedHealthcare, Johns Hopkins split | Payer mix in the largest for-profit health systems | Select Health CEO details MA strategy in '26 | Presbyterian names insurance president | Colo. moves to offset rising ACA costs

August 26, 2025 1. Johns Hopkins goes out of network with UnitedHealthcare Full story 2. Payer mix in the largest for-profit health systems Full story 3. AI is moving payment integrity from automation to transformation—see how it’s reshaping accuracy and…

Judge pauses parts of ACA rule | MA plan, DOJ settle over fraud scheme | Jefferson Health Plans posts $170M loss | Ohio system to stop accepting out-of-network patients | GLP-1s linked to lower cancer risk

August 25, 2025 1. Judge pauses parts of new ACA 'integrity' rule Full story 2. North Carolina Medicare Advantage plan settles with DOJ over identity theft scheme Full story 3. How Aetna Medicare is rethinking oncology strategy here. 4. Jefferson Health…

UnitedHealth stock whiplash | Cambia, BCBS ND to affiliate | HHS launches Medicare, Medicaid reform committee | Elevance expands food as medicine work | Highmark reports health plan pressures

August 22, 2025 1. As federal lawmakers sell UnitedHealth stock, Warren Buffet swoops in Full story 2. Cambia, BCBS North Dakota announce strategic affiliation Full story 3. Personalization without compliance risk? How some health plans are doing it: here. 4. HHS…

UnitedHealth, Elevance pull Colo. ACA plans | NY payer cutting jobs | Lowest-rated MA plans in '25 | CVS to pay $290M in false claims lawsuit | UnitedHealth forms oversight committee

August 21, 2025 1. UnitedHealth, Elevance scaling back ACA offerings in Colorado Full story 2. New York payer cutting 59 jobs Full story 3. Gaps in care slowing improvements? Embed alerts in the EHR. More info: here. 4. UnitedHealth names…

Elevance loses stars lawsuit | Judge blocks MA broker pay restrictions | Ga. places payer into receivership | Federal health plans to end gender-affirming care coverage | $2.8 billion BCBS settlement approved

August 20, 2025 1. Elevance loses $375M Medicare Advantage star ratings challenge Full story 2. Judge rules against Medicare Advantage broker pay restrictions Full story 3. Cut friction across member touchpoints — a proven personalization roadmap here. 4. Georgia payer…

Top MA plans for member satisfaction | UnitedHealth buys gastro physician group | Maine system cuts ties with Anthem | Trump revokes EO on competition | Iowa's Medicaid work rules start in '26

August 19, 2025 1. Top Medicare Advantage plans for member satisfaction in 2025: J.D. Power Full story 2. UnitedHealth's SCA Health acquires U.S. Digestive Health Full story 3. Personalization without compliance risk? How some health plans are doing it: here.…

Providence sues Kaiser over ED claims | CBO warns of $500B in Medicare cuts | BCBS Mass. posts $130M Q2 loss | Ga. fines insurers over mental health parity | 7 drugs in shortage

August 18, 2025 1. Providence sues Kaiser over ED claims Full story 2. CBO report warns of nearly $500B in potential Medicare cuts Full story 3. Medicare Advantage growth strategies: Find out what's working in markets across the nation at…

Employers expecting 10% rise in care costs | Sanford Health Plan eyes rural MA growth | Oscar, Hy-Vee launch joint plan | CMS lifts enrollment freeze on Centene plan | Aetna beats AvMed for county contract

August 15, 2025 1. Employers expect 10% rise in healthcare costs for 2026: 4 notes Full story 2. Where Sanford Health Plan's CEO is eyeing a 'significant opportunity for growth' in Medicare Advantage Full story 3. $28B in Medicare wound care…