Payer Issues Archives - Page 6 of 167 - Becker's Payer Issues

Optum begins Minn. Medicaid audit | CMS lifts enrollment freeze on Fla. MA plan | HonorHealth acquires Cigna care group | NM sees record ACA enrollment | Wegovy pill hits market

Optum has started reviewing Minnesota Medicaid claims and New Mexico’s move to replace ACA subsidies January 5, 2026 1. Optum begins Minnesota Medicaid audit; governor won't seek reelection Full story 2. CMS lifts enrollment freeze on Florida Medicare Advantage plan…

Insurance policy changes: A 2026 breakdown | Medi-Cal ends weight loss drug coverage | Anthem, Mount Sinai split | 14 systems dropping MA plans | 11 UnitedHealth updates

ACA enhanced subsidies have expired and the nation’s largest Medicaid program is cutting weight loss January 2, 2026 1. Notable health insurance policies taking effect in 2026 Full story 2. California Medicaid ends weight loss drug coverage Full story 3.…

Payers face 'deteriorating' 2026 outlook | Optum CEO, Mark Cuban square off | How states are responding to expiring ACA subsidies | 15 health systems dropping MA plans | 6 GLP-1 updates

Optum’s CEO and Mark Cuban tussled over drug rebates and Fitch says insurers are facing a tough 2026 December 31, 2025 1. 'Give me a name of one of your biggest customers so I can call them': Optum CEO, Mark…

CMS pitches new payer price transparency rules | States most affected as ACA subsidies expire | Change cyberattack lawsuit to move forward | What 6 Elevance leaders told Becker's in '25 | OIG flags $289M in Medicaid payments for deceased enrollees

GOP-led states are likely to be most affected by expiring ACA subsidies and price transparency rules December 30, 2025 1. States facing steepest coverage losses as ACA subsidies expire Full story 2. CMS proposes new price transparency rules Full story…

Lawmakers want probe of Elevance's new hospital penalty | Judge blocks Idaho's MA moves against UnitedHealth | CMS under Dr. Oz: 20 key actions | Anesthesia providers sue Aetna, Cigna | GLP-1 coverage in '25: 4 notes

Federal lawmakers are weighing in on Elevance’s new 10% hospital penalty and we recap Dr. Oz’s first December 29, 2025 1. Lawmakers call for investigation of Elevance's new hospital penalty for using out-of-network providers Full story 2. Federal judge blocks…

Tenet, Cigna negotiations heat up | CMS' GLP-1 model: 7 notes | Health insurance is a top benefit for workers | SCAN CEO talks regional MA plans | Americans face unaffordable care: Study

Tenet launched a campaign amid Cigna negotiations, and CMS' BALANCE model December 26, 2025 1. Tenet, Cigna tensions heat up as contract deadline nears Full story 2. CMS kicks off GLP-1 model: 7 notes Full story 3. Autonomous & proactive…

Aetna to settle LGBTQ+ fertility lawsuit | Bankrupt hospital sues BCBS of Ala. | Faith-based investors press UnitedHealth for acquisition report | BCBS of Vt. calls out hospital costs | 19 payer CEO moves

Aetna to settle a lawsuit over fertility treatments, and BCBS of Alabama also hit with legal action December 23, 2025 1. Aetna to settle discrimination lawsuit over fertility treatments Full story 2. Hospital sues BCBS of Alabama over reimbursement amid…

UnitedHealth's audit: 10 notes | CMS pitches 2 Medicare drug-pricing models | Rural health funding office created | Will '26 be ICHRA's year? | 19 payer M&A deals

UnitedHealth shares companywide audit findings, and CMS' Medicare drug-pricing models December 22, 2025 1. UnitedHealth releases companywide policy audit report: 10 things to know Full story 2. CMS proposes 2 Medicare drug-pricing models Full story 3. Autonomous & proactive —…

Hospitals to Elevance: Drop 10% penalty policy | CMS debuts LEAD model | Minn. takes control of UCare | Humana received $10.5M in MA overpayments: OIG | More GLP-1s aim to enter market

Hospitals want Elevance to drop its new out-of-network penalty policy and CMS rolls out a new ACO mo December 19, 2025 1. Hospital groups call on Elevance to rescind 'punitive' 10% hospital penalty for using out-of-network providers Full story 2. CMS' long-term…

UnitedHealthcare delays RPM policy | Payer CEO eyes a future without prior auths | Petition to force vote on ACA subsidies | Humana CEO elected AHIP chair | What 5 Optum execs told us this year

UnitedHealthcare is delaying a controversial RPM coverage policy and there may be a vote on extendin December 18, 2025 1. UnitedHealthcare delays new remote physiologic monitoring coverage policy Full story 2. 'What if we could eliminate prior authorizations?': Why this…