Payer Issues Archives - Page 4 of 168 - Becker's Payer Issues

CMS: MA clawbacks will begin soon | Aetna cuts 300+ jobs | Cigna to overhaul PBM in FTC deal | Optum rolls out new prior auth tools | 12 best payer tools in '26: KLAS

CMS is going to ramp up MA audits and Cigna has agreed to make big PBM changes February 5, 2026 1. Aetna to cut more than 300 jobs Full story 2. CMS says Medicare Advantage overpayment recoveries will begin soon Full…

Kaiser enters Nev. | Novo Nordisk hires Optum exec | MA plans boast annual enrollment gains | CommonSpirit, Cigna split in 2 states | Humana deepens Google ties

Kaiser is officially moving into Nevada and MA plans are boasting big enrollment gains February 4, 2026 1. Kaiser Permanente enters Nevada with health plan joint venture Full story 2. Novo Nordisk hires former Optum exec Full story 3. Improve quality,…

Elevance sues 4 execs over noncompetes | Aetna names Medicaid president | Fitch issues proposed MA rate warning | One-third of insured adults: Prior auth is ‘major burden’ | HDHPs linked to lower cancer survival

Elevance is suing former execs again over noncompetes and a new poll reveals prior auth burden February 3, 2026 1. Elevance sues 4 former execs over noncompete violations Full story 2. Aetna COO tapped to lead Medicaid division Full story…

Calif. fines Anthem | 17 payers shifting priorities | States respond to expired ACA subsidies | Ascension 'taking a closer look' at MA | 7 payers cutting jobs

Insurers are shifting priorities in 2026 and Calif. has fined Anthem over member complaints February 2, 2026 1. How 17 health plans are shifting priorities in 2026 Full story 2. California fines Anthem Blue Cross $15M over handling of member…

Mangione won’t face death penalty | DOL pitches PBM pay transparency | BCBS profit margins fall | CMS rule to phase out Medicaid provider taxes | 53 million MA prior auths in '24: 6 notes

Luigi Mangione won’t face the death penalty and the Labor Dept. is targeting PBM transparency January 30, 2026 1. Luigi Mangione won't face death penalty, judge rules Full story 2. Labor Department proposes PBM compensation disclosure rule for self-insured plans…

A bad week for insurers | CMS snags $600M to support Medicaid work rules | CVS, Horizon BCBS Medicaid to split | ACA enrollment drops to 23M | 5 M&A updates

From disappointing CMS news to massive stock selloffs, insurers are having a tough week January 29, 2026 1. A bad week for health insurers Full story 2. ACA enrollment falls to 23 million for 2026 Full story 3. Health insurance…

UnitedHealthcare projects 2.8M fewer members | Horizon NJ cuts jobs | Elevance posts $5.7B profit in '25 | Providers winning 88% of No Surprises disputes | Providence CEO calls for MA 'reset'

UnitedHealthcare is set to lose millions of members and another Blues plan is cutting jobs January 28, 2026 1. UnitedHealthcare expects to lose up to 2.8 million members in 2026 Full story 2. Horizon BCBS New Jersey lays off 242…

UnitedHealth projects '26 revenue decline | CMS pitches flat MA payments in '27 | Texas governor orders Medicaid fraud probe | CVS accused of impeding pharmacy competition | 8 prior auth updates

UnitedHealth is projecting a revenue decline in 2026 and CMS won’t boost MA rates by much January 27, 2026 1. UnitedHealth's 2025 profit dips to $12.1B Full story 2. CMS proposes nearly flat Medicare Advantage payments for 2027: 6 notes Full story…

Payer CEOs urge 'deescalation of tensions' | ND approves BCBS, Cambia deal | CareFirst sues over MA star ratings | Mangione trial to begin in Sept. | Alignment taps Optum exec for chief digital role

Payer CEOs urge calm after weekend of violence in Minnesota and CareFirst is the latest to sue CMS January 26, 2026 1. Payer CEOs call for 'deescalation of tensions' in Minnesota Full story 2. CareFirst BCBS sues over 2026 Medicare Advantage…

Congress grills payer CEOs | Ind. bill targets Elevance's out-of-network penalty | Payers prep for major winter storm | House passes health spending package | Mo. eyes prior auth reform

Payer CEOs squared off for hours with House lawmakers and Indiana is targeting Elevance’s out-of-net January 23, 2026 1. 'Vertical integration is destroying people's ability to access care': Payer CEOs face bipartisan congressional grilling Full story 2. Hospital, provider groups…