Payer Issues Archives - Page 4 of 179 - Becker's Payer Issues

Optum taps AI chief | UnitedHealthcare calls for IDR reform | Senate blocks move to repeal Medicare prior auth pilot | States ranked by self-funded, fully insured plans | A hidden cost of the GLP-1 boom

UHC wants changes to No Surprises arbitration + Senate blocks move to repeal WISeR July 17, 2026 1. UnitedHealthcare: No Surprises arbitration system ‘needs to be reformed’ Full story 2. Optum names chief AI officer Full story 3. Learn how Medica…

UnitedHealth posts $5.5B Q2 profit | Senators press MA insurers on AI-driven denials | Elevance signals more Medicaid exits | How Regence Ore. kept 98% of commercial members | 10 providers seeking payer talent

UnitedHealth boosts its margins + senators up the scrutiny on AI-driven denials in MA July 16, 2026 1. UnitedHealth posts $5.5B profit in Q2 Full story 2. Senators press UnitedHealth, Humana, CVS on AI-driven Medicare Advantage coverage decisions Full story…

Elevance Q2 profits down 16% | SCAN, Alignment sue over '26 star ratings + Alignment loses '25 appeal | Insurers launch No Surprises ad blitz | CVS, FTC settle insulin case for $13B

Elevance profit margins dip + more MA plans sue CMS over ’26 star ratings July 15, 2026 1. Elevance reports $1.5B profit in Q2, membership dip Full story 2. SCAN, Alignment sue CMS over 2026 star ratings recalculation Full story…

Optum, Anthropic partner | CMS reprimands AI vendor in Medicare pilot | Judge tosses Elevance's No Surprises lawsuit | CVS CEO questions GLP-1 ROI | Brand-name drug denials surge

Optum is partnering with Anthropic + Elevance loses another No Surprises lawsuit to HaloMD July 14, 2026 1. Optum partners with Anthropic Full story 2. Judge dismisses another No Surprises lawsuit from Elevance Full story 3. As Medicare and Medicaid…

Blue Cross NC regains state health plan contract | Ind. hospital expands services after ICHRA switch | Why 'payvider' isn't a useful term | Claude now handles insurance claims | 18 payer C-suite exits

North Carolina employee health plan switches back to BCBS + we explore the term ‘payvider’ July 13, 2026 1. Blue Cross regains North Carolina’s state health plan contracts while Aetna loses out Full story 2. Indiana hospital credits expanded services…

Elevance exits DC Medicaid | Democrat-led bill aims to rein in MA upcoding | BCBS Minn. expands AI-powered 'front door' | A new 'Medicare for All' test | Anthem BCBS Nev. names leader

Elevance is leaving DC’s Medicaid program early + House Democrats eye MA upcoding in new bill July 10, 2026 1. Elevance to exit D.C. Medicaid managed care program Full story 2. BCBS Minnesota expands AI-powered ‘front door’ Full story 3. Medication…

Whistleblower accuses Alignment of profit inflation | Memorial Hermann to close commercial insurance unit | UHC rolls out lifestyle spending accounts | Cigna names strategy, innovation chief | CVS, Omnicare reach $440M DOJ settlement

A former top exec at Alignment alleges profit manipulation + Memorial Hermann retreats on insurance July 9, 2026 1. Whistleblower accuses Alignment of inflating profits to fuel exec bonuses in new lawsuit Full story 2. Memorial Hermann to shutter commercial…

5 BCBS updates | Former Optum president dies at 59 | ACA premiums to see another jump in '27 | 5K pharmacies sue Prime Therapeutics | How 4 payers are innovating in specialty pharmacy

ACA premiums are poised to jump again next year as nearly every state reports a decline in enrollmen July 8, 2026 1. Former Optum president dies at 59 Full story 2. 5 Blue Cross Blue Shield updates Full story 3. Are…

BCBSLA loses star ratings appeal | UnitedHealth defends in-home MA diagnoses | Centene to exit Ark. Medicaid expansion | Medicare eyes reimbursement for AI diagnostics | 15 payer M&As

UnitedHealth posts a new MA coding defense + BCBS Louisiana loses latest star ratings challenge July 7, 2026 1. UnitedHealth: 97% of Medicare Advantage in-home diagnoses supported by medical records Full story 2. Centene to leave Arkansas Medicaid expansion program,…

Elevance sues again over star ratings | Cigna welcomes new CEO | Optum Financial buys benefits admin platform | Payers ranked by '26 MA bonus payments | BCBSVT shelves proposed product line

Elevance is suing CMS again over MA star ratings + an actuary takes the lead at Cigna July 6, 2026 1. Elevance sues CMS over 2026 star ratings following Clover win Full story 2. 5 things to know about Cigna’s…