Payer Issues Archives - Page 5 of 161 - Becker's Payer Issues

UnitedHealthcare calls out 'cynical' contract talks | 7 payers exiting MA | No Surprises IDR process continues amid shutdown | Molina sued by investor over care costs | 29 payers cutting jobs

October 7, 2025 1. UnitedHealthcare calls out healthcare groups' 'cynical' contract negotiation strategy Full story 2. 7 insurers fully exiting Medicare Advantage Full story 3. Navigating Payer Compliance with CERIS’s Cereasa Horner — insights on AI, oversight challenges, and strategies to stay…

UnitedHealth investor urges separate CEO, chair roles | 2 health system plans exit MA | Confusion ahead of open enrollment | NM lawmakers move to preserve ACA credits | Payer 'mischief' plagues CommonSpirit: CFO

October 6, 2025 1. UnitedHealth shareholder proposes separating CEO, board chair roles Full story 2. Big MA market exits are not fazing all insurers Full story 3. This VBC-aligned autism model expands access — without more provider hours. See how…

UnitedHealth taps AI chief | Blue Cross NC offers buyouts | 20% of Humana members in 4+ star MA plans in '26 | Judge denies states' bid to halt new ACA rules | BCBS Vt. exits MA

October 3, 2025 1. UnitedHealth Group taps AI chief Full story 2. Blue Cross North Carolina offers employee buyouts Full story 3. Even de-identified data isn't safe. The hidden AI privacy risk leaders need to know — here. 4. 20%…

Reline: Cigna debuts downcoding policy | UnitedHealthcare cuts CRNA reimbursement | CMS services that will, won’t continue during shutdown | Medicare prior auth pilot: 4 notes | 9 ACA subsidy updates

October 2, 2025 1. Cigna debuts controversial downcoding policy; on hold for California HMO plans Full story 2. UnitedHealthcare cut to CRNA services goes into effect Full story 3. New case study: LTACHs cut sepsis readmissions — and payer costs. See the…

Insurers launch MA plans for '26 | Humana to pay $32M after False Claims settlement | Shutdown begins: What to know | 8 ACA subsidies updates | BCBS Vt. names CEO

October 1, 2025 1. Insurers launch 2026 Medicare Advantage plans Full story 2. Court orders Humana to pay $32M in fees following False Claims settlement Full story 3. 40% of your members skip preventive care—and it costs you $20 million+. See…

ACA subsidies extension talks continue | 30 systems dropping MA plans | AHA urges payers to keep prior auth promise | 10 providers seeking payer talent | 3 ACA rebates updates

September 30, 2025 1. Where ACA enhanced subsidies stand: 7 updates Full story 2. 30 health systems dropping Medicare Advantage plans Full story 3. CMS ramping up audits in MA and Medicaid. Is your plan ready? Find out here. 4.…

CMS predicts MA enrollment decline | UnitedHealth wants securities fraud lawsuit tossed | NCQA taps Humana exec as CEO | Court OKs Elevance behavioral health coverage settlement | US to impose branded drugs tariff

September 29, 2025 1. UnitedHealth asks judge to toss lawsuit from California pension fund Full story 2. CMS expects Medicare Advantage enrollment to dip in 2026 Full story 3. Fix claim errors before they happen—real-time data exchange boosts accuracy and…

Judge tosses MA audit rule | Most regional payers losing money | ACA subsidy sunset could cost healthcare $32B | CMS lifts enrollment freeze on Mass. payer | 8 MA-focused bills to know

September 26, 2025 1. Judge sides with Humana, tosses Medicare Advantage audit rule Full story 2. Most regional payers are operating at a loss: 5 notes Full story 3. How Cigna, Humana + others are adapting to Medicare Advantage volatility…

PBMs draft reform plan | HCSC playing the long game in MA | UnitedHealthcare to pay $359M in rebates | Medicare prior auth pilot draws lawmaker scrutiny | 21 top payer workplace cultures

September 25, 2025 1. Health Care Service Corp. is playing the long game in Medicare Advantage Full story 2. UnitedHealthcare to pay $359M in rebates Full story 3. Shared mobile device use is rising fast — and so are risks.…

A conversation with UnitedHealthcare's commercial CEO | Lawsuit targets Elevance's Zepbound coverage denial | Ore. payer's Medicaid nonrenewal affects 100,000 | Centene to pay $87.5M in ACA rebates | Best MA plans in each state

September 24, 2025 1. AI, GLP-1s, and the new UHC Store: A conversation with UnitedHealthcare's commercial CEO Full story 2. Lawsuit seeks to reverse Elevance's Zepbound coverage denial Full story 3. Real-time data is changing claims processing. Discover how payers…