Payer Issues Archives - Page 6 of 161 - Becker's Payer Issues

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…

Centene to pay $87M in ACA rebates | How this insurer stays in the top 1% for care | CVS subsidiary files for bankruptcy | NH pauses Anthem contract | 13 payer M&A updates

September 23, 2025 1. How this insurer stays in the top 1% for quality care Full story 2. Centene to pay $87M in ACA rebates to Missouri policyholders Full story 3. Patient-specific insights, directly in the EHR. The future of…

Hospital roots shape Blue Shield of Calif.'s new CEO | Aetna scales MA hospital program | Elevance taps OpenAI for employee education | Optum Insight names CEO | What's to blame for claim denials?

September 22, 2025 1. How safety-net experience shapes Blue Shield of California's new CEO's perspective Full story 2. Aetna expands Medicare Advantage care coordination program to 10 hospitals Full story 3. Improving transparency starts with stronger payer-provider data sharing. Learn how…

CMS posts MA provider directories final rule | The best commercial plans in each state: NCQA | States ranked by uninsured increases post-ACA subsidy expiration | 10 UnitedHealth updates | 4 notes about GLP-1s

September 19, 2025 1. CMS posts final rule requiring submission of Medicare Advantage provider directories Full story 2. The best-rated commercial health plans in each state: NCQA Full story 3. From GLP-1 costs to chronic care ROI: Hear what payer…

Bill would bar insurers from buying clinics | DOJ sues Calif. payer over Medicaid overpayments | Insurers uphold vaccine coverage | Best MA plans in '25: NCQA | Elevance sues former exec over noncompete

September 18, 2025 1. Lawmakers debut bill to bar insurers from buying medical clinics Full story 2. Justice Department sues California payer over $320M in alleged Medicaid overpayments Full story 3. Real-time payer-provider connections are reshaping transparency—see how they can…