Payer Issues Archives - Page 5 of 183 - Becker's Payer Issues

Ohio Chamber sues UHC | Texas investigating TriWest | 6 new reimbursement changes this month | Elevance-BCBS venture to exit La. Medicaid | Johns Hopkins Health Plans taps interim CEO

Ohio Chamber says UHC poached its members + Elevance exits another Medicaid program September 2, 2026 1. Ohio Chamber sues UnitedHealthcare over alleged effort to poach members Full story 2. 6 payer reimbursement changes to know in September Full story…

UHC pushes 30% prior auth reduction | MA plan hit with enrollment freeze again | 5 healthcare fights on the ballot | Cuban: Healthcare contracts are like 'Fight Club' | HDHPs don't slow long-term spend: Study

The nation’s largest insurer cuts prior auth requirements + healthcare top of mind ahead of midterms September 1, 2026 1. UnitedHealthcare to drop prior authorization requirements for 1,700 services Full story 2. Massachusetts Medicare Advantage insurer hit with another enrollment…

DOJ ups MA fraud crackdown | Centene names CIO | Wis. payer goes on M&A offense | Labor Dept. eyes assoc. health plan expansion | Fla. sues PBMs for alleged price fixing

Feds’ MA fraud crackdown continues + a regional Wis. payer details expansion plans August 31, 2026 1. DOJ steps up crackdown on Medicare Advantage upcoding Full story 2. ‘No-regret moves’: A regional Wisconsin insurer goes on the acquisition offense Full…

Md. sues UnitedHealth over Medicaid contract | Elevance loses bid for quick star ratings recalculation | Calif. legislature passes prior auth bill | Cigna ties cash benefits to medical claims | Medicare's GLP-1 program gains traction

Elevance denied a quick star ratings redo + UnitedHealth sued over Md. Medicaid issues August 28, 2026 1. Maryland sues UnitedHealth for $380M over Medicaid administration issues Full story 2. Federal court denies Elevance’s bid for emergency 2026 star ratings…

Villages Health inks $541M MA fraud settlement | Grand jury: DeSantis team misused Centene funds | NJ man sentenced in $50M insurance fraud scheme | Employers' GLP-1 cost strategy: 6 notes | GuideWell names CFO

Villages Health settles MA fraud allegations + the latest in employers’ GLP-1 cost strategy August 27, 2026 1. Humana’s Villages Health to pay $541.5M to settle Medicare Advantage fraud allegations Full story 2. $10M from Florida’s Centene Medicaid settlement misappropriated…

No Surprises IDR volume up 77% | Ex-Optum employee sentenced for fraud | Insurers' underwriting losses skyrocket | Henry Ford Health's MA membership jumps 46% | Blue Shield of Calif. cuts 60 jobs

No Surprises arbitration costs hit $22B + insurers see massive underwriting losses August 26, 2026 1. Former Optum director sentenced to 3 years in prison for defrauding company Full story 2. No Surprises dispute volume grows 77% in one year,…

3 new payer presidents | Disney, Starbucks among employers reducing benefits | States reject Medicaid GLP-1 deal | Insurer margin recovery dampened by high costs: Moody's | Union health plan sues OhioHealth

Big employers cutting benefits amid rising costs + states reject Trump’s Medicaid GLP-1 deal August 25, 2026 1. From Disney to Starbucks, big employers are pulling every lever to contain health costs Full story 2. Highmark taps Aetna exec to…

Payer CEO calls for prior auth ban | The AI jobs payers want to fill | Short term plan marketing up as ACA enrollment falls: Study | Cigna accused of behavioral underpayments | Ore. to launch state-based marketplace

A payer CEO’s call to ban prior auth + short term plan marketing surges amid ACA struggles August 24, 2026 1. Health insurer CEO: ‘Make prior authorization illegal’ Full story 2. The AI jobs health insurers are looking to fill right…

SCAN doubles down on 'hostile marketing' | Aetna to cut MA broker pay | Mount Sinai policy draws payer cease and desist | Employer care costs to rise 9.5% in '27: Aon | Ore. eyes ACA enrollment caps

An unconventional MA ad campaign will run again this fall and Aetna is cutting broker pay August 21, 2026 1. ‘We’re in wartime’: As major insurers continue pulling back on Medicare Advantage, SCAN places another contrarian bet Full story 2.…

BCBS Tenn. drops AI work tracking tool | Medi-Cal plans decry asset limit crunch | Humana taps new CMO | The latest in the No Surprises saga | Wide gaps in Medicare coverage knowledge: Survey

An insurer pivots on AI work tracking tool + the latest in the No Surprises saga August 20, 2026 1. BCBS Tennessee pivots away from AI tool that monitored employee work Full story 2. Medi-Cal plans brace for ‘devastating’ asset limit crunch…