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Payer Issues

UnitedHealth keeps getting bigger + exploring payers’ recent M&A activity July 31, 2026 1. UnitedHealth Group becomes 4th largest company in the world Full story 2. Big payers keep betting on health services — but discipline is still the name…

Humana beats Q2 profit estimates + the ACA subsidy fallout diverges for insurers, hospitals July 29, 2026 1. Humana turns $694M Q2 profit amid Medicare Advantage, CenterWell growth Full story 2. ACA subsidy fallout favors insurers, pressures hospitals’ payer mix Full…

Jefferson sues another payer over disputed pay + 5 payers entering ACA markets July 27, 2026 1. Jefferson Health sues Independence Blue Cross over nearly $100M in disputed payments Full story 2. Excellus BCBS to face former director’s racial discrimination…

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An unsealed whistleblower suit alleges MA fraud at Cambia + Aetna’s CMO weighs in on the AI bot war July 24, 2026 1. Whistleblower alleges Cambia knowingly kept Medicare Advantage overpayments Full story 2. Aetna’s chief medical officer pushes back…

No Surprises arbitration payouts explode + CMS appeals a landmark star ratings ruling July 23, 2026 1. CMS appeals Clover’s Medicare Advantage star ratings win Full story 2. Insurer pricing, claims data transparency bills advance in Congress: What to know Full…

Group plan e-delivery rule could mean $3.9B in savings + a Medicaid plan joins Calif. ACA market July 22, 2026 1. Labor Department pitches electronic disclosure rule for group health plans Full story 2. CalOptima to be California’s only new…

UnitedHealth loses a defamation lawsuit + HHS pauses more state Medicaid funds July 21, 2026 1. Judge dismisses UnitedHealth’s defamation lawsuit against the Guardian Full story 2. HHS defers $1B+ in Medicaid funds to Minnesota, California Full story 3. Medicaid is entering…

Judge blocks ACA changes again + UHC expects to keep more MA members than it thought July 20, 2026 1. Judge pauses ACA catastrophic plan expansion, 7 other provisions Full story 2. UnitedHealthcare reduces MA enrollment loss projection for 2026…

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