Payer Issues Archives - Page 3 of 177 - Becker's Payer Issues

25 states sue over Medicaid work rules | Centene exits NH ACA market | Kan. sues Aetna over employee plan fund management | BCBS Mass. to cut some PPO plans | UHC, CareFirst win midyear rate increases in Md.

Half of the states are suing over Medicaid work rules + Kansas sues Aetna over employee plan issues June 30, 2026 1. 25 states sue Trump admin over Medicaid work requirements — 8 things to know Full story 2. Kansas…

ACA loses 3 million enrollees | 2 states prep for Medicaid work rules | CMS rewrites MA star ratings mid-game | UnitedHealth taps CIO for Optum Insight | Physicians vs. prior auth: 10 updates

Plus: Where physicians stand with prior auth June 29, 2026 1. ACA sees 3 million enrollee drop: 5 notes Full story 2. Montana, Arkansas to kick off Medicaid work requirements July 1 Full story 3. Becker’s Fall Payer Issues Roundtable convenes…

Elevance pays CMS $342M amid MA sanctions threat | Kaiser owes $82M in emergency reimbursement dispute | 31 Dems press CMS on Medicare prior auth pilot | 5 takeaways from 2027 ACA rate filings | Centene's new board member

Plus: Lawmakers pitch out-of-pocket cap for traditional Medicare beneficiaries June 26, 2026 1. Elevance pays CMS $342M amid Medicare Advantage sanctions threat Full story 2. Kaiser's health plan to pay $82M in emergency reimbursement dispute Full story 3. "Different opinions and…

The new era of health plan M&A | UnitedHealth 401(k) lawsuit to proceed | 7 insurer ACA market exits | Optum eyes NY specialty sales | Walgreens joins Medicare GLP-1 Bridge

Plus: UnitedHealthcare, Main Line Health work to finalize agreement June 25, 2026 1. ‘Surgical portfolio moves’: Inside the new era of health plan M&A Full story 2. Lawsuit alleging mismanagement of UnitedHealth 401(k) forfeitures to move forward Full story 3. $80B…

UnitedHealth opens its doors | CareFirst sues brokers over $51M 'fraud machine' | Elevance to exit Ohio small group ACA market | BCBS Mich. to overhaul supervised clinician payments | DOJ charges 455 in $6.5B fraud schemes

A look inside UnitedHealth + CareFirst alleges brokers concocted $51M fraud scheme June 24, 2026 1. A year after promising ‘change and reform,’ UnitedHealth opens its doors Full story 2. CareFirst BCBS sues brokers over $51M ‘international insurance-fraud machine’ Full story 3.…

CDC nominee preps to leave UnitedHealth | Premiums may drop under anti-competitive hospital contracting ban: White House | Pa. bill pitches insurer CEO liability for denials | CVS to join Medicare GLP-1 program | 23 highest-paid healthcare leaders

The CDC could soon have a leader that hails from UHC + CVS is joining Medicare’s GLP-1 program June 23, 2026 1. CDC nominee prepares to depart UnitedHealth Full story 2. Employer-sponsored insurance premiums could drop 6.5% with anticompetitive hospital contracting…

Mangione reverses on psych defense | CBO wants more No Surprises research | Payers rebuke OIG's MA post-acute denials report | 15 insurers cutting jobs | 10 UnitedHealth updates

Feds want more info on No Surprises impact + Mangione won’t pursue a psych defense in UHC trial June 22, 2026 1. Luigi Mangione reverses on psychiatric defense in UnitedHealthcare CEO case Full story 2. Health plans challenge OIG’s Medicare Advantage…

A slow erosion of the traditional provider network | 17 health plan C-suite exits | Mark Cuban takes Cost Plus playbook to ASCs | Managed Medicaid's 'ghost provider' problem | 8 recent GLP-1 findings

Plus: What’s up with price transparency laws? June 19, 2026 1. The slow erosion of the traditional provider network Full story 2. Mark Cuban built Cost Plus Drugs. Now he’s coming for how ASCs get paid Full story 3. Payment integrity…

CMS recalculates MA star ratings bonuses | UnitedHealthcare faces split with 45-hospital network | 24 systems exit MA | Bankrupt hospital loses BCBSAL rate dispute | 'Is AI going to take my job?': What's keeping health plan workers up at night

Plus: PBMs take state laws to federal court June 18, 2026 1. CMS recalculates MA star ratings payments in wake of Clover lawsuit Full story 2. 24 health systems dropping Medicare Advantage plans Full story 3. Two days, 500+ payer…

Luigi Mangione to use psych defense | 6 recent MA fraud settlements | Fairview to drop UnitedHealthcare MA | Wis. payer buys women's health firm | DOJ sues NY over alleged Medicaid fraud

The DOJ alleges Medicaid fraud in NY + the latest in the UnitedHealthcare CEO killing case June 17, 2026 1. Luigi Mangione to use psychiatric defense in UnitedHealthcare CEO killing state case Full story 2. 6 recent Medicare Advantage fraud…