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

Medicare open enrollment begins | Judge rebuffs Humana's 2nd star ratings lawsuit | Minn. shutters unlicensed insurer | UnitedHealthcare, Ascension Wis. ink contract | Telehealth pay confusion amid shutdown

Medicare open enrollment, Humana’s stars lawsuit rebuffed, and telehealth pay issues October 15, 2025 1. Medicare open enrollment begins: 6 notes Full story 2. Judge rebuffs Humana's renewed star-ratings suit Full story 3. Watch our expert webinar Maximize Your ROI…

Centene inks $40M network directory settlement | GLP-1 coverage could raise premiums by 14% | Payers, providers diverge on rising No Surprises costs | Mich. extends insurer tax amid Medicaid cuts | CVS outlines future of pharmacy

Network directory settlement, GLP-1 effects, and ongoing payer-provider tensions October 14, 2025 1. California settles network directory lawsuit with Centene for over $40M Full story 2. Covering GLP-1s could raise premiums by 14%: Study Full story 3. 3 genAI use…

Highest, lowest-rated MA plans in '26 | Calif. enacts PBM reform | Cigna OKs $5.7M 'ghost network' settlement | HHS reverses some layoffs | Insured workers struggle with mental healthcare access: 5 notes

MA star ratings, PBM reform and mental health gaps — key payer updates this week October 13, 2025 1. Eighteen 5-star Medicare Advantage plans Full story 2. 23 Medicare Advantage plans rated below 3 stars Full story 3. GLP-1s alone aren't…

CMS posts MA star ratings | Optum to buy Mass. medical group | COVID-19 tester sues Aetna | How states are regulating AI and insurance | 3 ICHRA bills to know

Star ratings, AI rules and ICHRA bills — major payer moves and state actions October 10, 2025 1. CMS posts 2026 Medicare Advantage star ratings: 8 notes Full story 2. Optum to buy Massachusetts medical group Full story 3. BCBS…

BCBS Mass. offers buyouts | Calif. clamps down on private equity in healthcare | Judge dismisses Medicaid fraud case against 3 payers | Viewpoint: Vertically integrated insurers can exploit ACA rules | 5 GLP-1 updates

Insurers see shifts — from BCBS buyouts to new limits on private equity October 9, 2025 1. BCBS Massachusetts offers buyouts to 18% of workforce Full story 2. Judge dismisses Indiana Medicaid fraud case against Elevance, Centene, CareSource Full story…

Calif. reforms prior auth | Personal ties reshape payer-provider talks | Elevance wins age discrimination lawsuit | Highmark taps president | Medicare Part D in '26: 4 notes

October 8, 2025 1. California bill eliminating 'redundant' prior authorization barriers signed into law Full story 2. Why personal relationships among executives matter in payer-provider contract negotiations Full story 3. The 5 AI disruptors every healthcare exec should know: here. 4.…

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…