Payer Issues Archives - Page 6 of 179 - Becker's Payer Issues

CMS recalculates MA star ratings bonuses | UnitedHealthcare faces split with 45-hospital network | 24 systems exit MA | Bankrupt hospital loses BCBSAL rate dispute | 'Is AI going to take my job?': What's keeping health plan workers up at night

Plus: PBMs take state laws to federal court June 18, 2026 1. CMS recalculates MA star ratings payments in wake of Clover lawsuit Full story 2. 24 health systems dropping Medicare Advantage plans Full story 3. Two days, 500+ payer…

Luigi Mangione to use psych defense | 6 recent MA fraud settlements | Fairview to drop UnitedHealthcare MA | Wis. payer buys women's health firm | DOJ sues NY over alleged Medicaid fraud

The DOJ alleges Medicaid fraud in NY + the latest in the UnitedHealthcare CEO killing case June 17, 2026 1. Luigi Mangione to use psychiatric defense in UnitedHealthcare CEO killing state case Full story 2. 6 recent Medicare Advantage fraud…

Centene offers mass buyouts | BCBS profits sink | Judge vacates parts of ACA rule | HCSC to launch deductible-free plans | 10 recent billing fraud cases

Centene offers buyouts to most employees + BCBS plan losses climbed in 2025 June 16, 2026 1. Blue Cross Blue Shield plans ranked by 2025 profits Full story 2. Centene offers buyouts to most employees Full story 3. 500+ payer…

Medical cost trend to hit 9% in '27 | Cigna sues Tenn. over PBM law | UnitedHealth, FTC near insulin rebates deal | GLP-1s tied to $193K in lifetime health savings | Aetna, Cigna signal Abridge interest

Health insurance costs are projected to skyrocket again in 2027 + Cigna sues Tenn. over PBM law June 15, 2026 1. Health insurance costs to hit 17-year high in 2027: Survey Full story 2. MA patients stay in hospital 11%…

Clover scores 2026 MA star ratings upgrade | MultiPlan's litigation saga | CareFirst, Caremark cleared in Zepbound sleep apnea lawsuit | Centene taps Ill. exec | CMS tightens leash on Medicaid demonstration waivers

Plus: Mending exits insurance, CMS launches health tech office June 12, 2026 1. Clover gets upgrade to 2026 Medicare Advantage star ratings Full story 2. What to know about MultiPlan’s litigation saga Full story 3. Elizabeth Seton Children’s Center is…

Elevance sues former exec over noncompete | Humana to sell $900M hospice stake | US tightens fraud oversight of federal health plans | Optum cuts 98 more jobs | 6 insurer ACA exits

Plus: Medi-Cal plan puts $1B toward rate increases, CMS taps Elevance alum June 11, 2026 1. Elevance sues former chief execution officer over noncompete agreement Full story 2. 6 insurers exiting ACA markets Full story 3. Becker’s Fall Payer Issues…

House panel votes to block WISeR funding | 500+ hospitals warned to post prices | 10 providers seeking payer talent | Optum cuts 92 jobs | CareFirst MA star ratings suit paused

The White House issues a price transparency warning + more job cuts at Optum June 10, 2026 1. House panel votes to block funding for WISeR prior authorization pilot Full story 2. White House warns 500+ hospitals to post price information…

CMS Medicare fines keep coming | 10 key MA numbers | Ill. awards Medicaid contracts | 7 hospital-insurer contract talks to watch | GoHealth files for bankruptcy

Illinois awards Medicaid contracts + more layoffs at Blue Shield of California June 9, 2026 1. CMS Medicare fines keep coming: 5 recent updates Full story 2. 10 key Medicare Advantage numbers to know in 2026 Full story 3. If you work…

7 recent MA suspensions, terminations | Lifepoint files underpayment complaint against insurers | Mass. prior auth regs take effect | Payers pitch 2027 ACA rates: 5 updates | GLP-1s and cancer: 6 things to know

Medicare Advantage enforcement roundup + Massachusetts prior auth reform takes effect June 8, 2026 1. 7 recent Medicare Advantage contract suspensions, terminations Full story 2. The health plan trends that will define the next few years Full story 3. ACA…

Cities challenge ACA changes again | Optum picks up clinics from Ascension-AmSurg deal | Health plan vendors to pay $57M over MA fraud allegations | Breaking down CMS' Medicaid work rules | 21% of Americans report coverage denials

Cities sue over CMS’s latest ACA reforms + Optum picks up clinics thanks to Ascension deal June 5, 2026 1. Cities, physician group sue CMS again over ACA changes Full story 2. Health plan vendors, founder to pay $57M over…