Payer Issues Archives - Page 5 of 168 - Becker's Payer Issues

False Claims Act settlements hit record | Trump's health plan: 3 big unanswered questions | 3 drugs to watch: Optum | Improper Medicare payments reach $28B | 5 'most admired' insurers

Big questions loom over Trump’s healthcare plan and False Claims Act settlements hit a record high i January 22, 2026 1. False Claims Act settlements, judgments top $6.8B in 2025: 6 notes Full story 2. 3 big questions about Trump's…

Payer CEOs prep for Congress | Congress' bipartisan health deal: 8 notes | ACA plans unaffordable in most markets: Study | The case for copay-only plans | 5 prior auth updates

Payer CEOs are headed to D.C. this week and Congress has pitched a new healthcare package January 21, 2026 1. Payer CEOs point to hospitals, drug manufacturers for rising costs ahead of congressional hearings Full story 2. Congress pitches bipartisan…

States ranked by ACA enrollment change | Hawaii BCBS, Hawaii Pacific Health proposal under fire | U of Utah Health Plans names part-time CFO | Alignment CEO at JPM | Missouri sues PBMs over insulin

States in order of ACA enrollment change, and affiliation tensions January 20, 2026 1. States ranked by ACA enrollment change since 2025 Full story 2. 'Too good to be true': Providers, insurers weigh in on potential HMSA, Hawaii Pacific Health…

Trump's 'Great Healthcare Plan': 3 notes | ACA open enrollment wraps | Top-rated plans for member experience | Wash. fines Kaiser over mental health parity | Mass. considers prior auth reform

Trump pitches a health policy framework and ACA open enrollment has wrapped January 16, 2026 1. Trump pitches healthcare policy outline aimed at lowering costs: 3 takeaways Full story 2. ACA open enrollment wraps: 6 things to know Full story…

Kaiser to pay $556M to settle MA case | Calif. payer to cut 3% of workforce | 4 Corewell hospitals leave UHC network | NY to reform prior auth | 4 payer M&A deals

Kaiser Permanente’s settlement, and L.A. Care Health Plan to lay off 225 January 15, 2026 1. Kaiser Permanente agrees to pay $556M to resolve Medicare Advantage whistleblower allegations Full story 2. California payer laying off 3% of workforce amid Medicaid…

UnitedHealthcare seeks to speed up rural MA pay | Ga. fines 11 insurers $25M | Senate delays ACA subsidy bill | BCBSND names president | 10 recent billing fraud cases

Georgia clamps down on mental health parity violations and an ACA subsidy bill is pushed again January 14, 2026 1. UnitedHealthcare launches accelerated Medicare Advantage payment program for rural hospitals Full story 2. Georgia issues $25M in fines to 11…

Where ACA subsidies stand | 5 healthiest, least healthy states: UnitedHealth | Humana, Lilly ink employer GLP-1 deal | Study flags AI-driven prior auth risks | 11 No Surprises updates

ACA enrollment is on the decline nationally and the No Surprises Act has become a legal battleground January 13, 2026 1. Where ACA subsidies stand: 5 updates Full story 2. 5 healthiest states in 2025 — and the least healthy:…

UnitedHealth used 'aggressive tactics' for MA pay: Senate report | Insurance industry sheds 28K jobs | BCBSA applauds House ACA vote | NY audit flags $19M in Anthem lapses | Details emerge in HMSA, Hawaii system's affiliation

A new Senate report calls out UnitedHealth’s ‘aggressive’ MA payment tactics and the insurance secto January 12, 2026 1. Senate finds UnitedHealth used 'aggressive strategies' in Medicare Advantage Full story 2. New York state employee plan audit identifies $19.3M in Anthem…

Payer CEOs to testify before Congress | House passes ACA subsidy extension | Senators widen UnitedHealth nursing home probe | 2 Mass. payers to merge | Fla. loses Medicaid unwinding case

Federal lawmakers are scrutinizing big insurers and Florida has lost a major Medicaid unwinding laws January 9, 2026 1. 5 payer CEOs to testify before Congress on rising healthcare costs Full story 2. House approves 3-year ACA subsidy extension Full…

Anthem sues 11 Prime hospitals | ACA subsidy talks continue | Insurers take ownership of health data group | NY Blues plans decry new state mandates | Catastrophic coverage in '26: 6 notes

Anthem is continuing its fight against No Surprises ‘abuse’ and talks continue around ACA subsidy so January 8, 2026 1. Anthem sues 11 Prime hospitals, alleges $15M in fraudulent No Surprises Act awards Full story 2. Senators near plan to…