Payer Issues Archives - Page 7 of 167 - Becker's Payer Issues

ACA subsidies face expiration as House vote stalls | Calif. fines 3 Centene plans | 97% of insurance markets are highly concentrated: AMA | Payers ranked by price transparency compliance | 14 AI moves in '25

The House won’t be voting on extending ACA subsidies and a new report shows wide variation in price December 17, 2025 1. House GOP won't call vote on ACA subsidy extension Full story 2. California fines 3 Centene health plans…

Humana insurance president retiring | Highest-quality health plans in Calif. | Payers losing half of medical review cases: Study | NH bill targets AI-driven claims audits | Highmark posts $69M loss through Q3

Humana’s insurance leader is retiring and New Hampshire steps into the payer-provider AI fight December 16, 2025 1. Humana insurance president to retire, replacement named Full story 2. Health plans losing nearly half of cases that reach independent medical review:…

House GOP pitches healthcare bill | Insurers fall short on price transparency: Study | UCare cuts 250 jobs | CVS settles Okla. PBM case | 10 largest insurers

GOP lawmakers pitch another healthcare bill and a new study calls payers' price transparency complia December 15, 2025 1. House floats new healthcare bill after Senate proposals fail Full story 2. Insurers not fully complying with price transparency rules: Study…

ACA enhanced subsidies headed for cliff | Highmark, BCBS Kansas City to affiliate | CMS launches lifestyle medicine Medicare pilot | Healthiest states for women, children: UnitedHealth | Best hospitals for maternity care

No solution reached for expiring ACA subsidies and BCBS consolidation continues December 12, 2025 1. Competing bills tackling ACA subsidies fail in Senate Full story 2. Highmark, BCBS Kansas City to affiliate Full story 3. What's helping pharmacies meet payer…

ACA enrollment is up — so far | La. cuts UnitedHealth Medicaid contract | Judge clears new NYC employee health plan | BCBS Texas, Ascension Texas face split | Medicaid work rules are coming: 8 things to know

ACA enrollment hasn’t slowed down and insurers are prepping for Medicaid work rules December 11, 2025 1. ACA enrollment tracking ahead of last year: 6 notes Full story 2. Louisiana cuts UnitedHealthcare Medicaid contract, affecting 330,000 enrollees Full story 3.…

GOP moves toward ACA subsidy expiration | WV sues Optum over opioid crisis | Minn. petitions for UCare takeover | 7 key payer reimbursement updates | CVS raises '25 outlook

Republicans aren’t pitching an ACA subsidy extension and Optum is accused of worsening the opioid cr December 10, 2025 1. GOP prepares vote on competing bill addressing ACA subsidy expiration Full story 2. West Virginia sues Optum over opioid crisis Full story…

CMS weighs in on MA broker pay | Hawaii BCBS could merge with health system | 2 former payer CEOs join Minn. systems' merger talks | Elevance expands doula care | Commercial GLP-1 coverage declines

CMS weighs in on the MA broker pay issue and a new vertically integrated system could form in Hawaii December 9, 2025 1. Hawaii health system, state's largest payer in merger talks Full story 2. CMS: States cannot regulate Medicare Advantage…

Fla. floats ICHRA marketplace | UnitedHealth accuses Tenn. system of 'PR stunt' lawsuit | Elevance expands AI assistant to 22M members | ACA approval hits new high | 4 MedPAC payment recs for '27

UnitedHealth calls a hospital’s MA lawsuit a publicity stunt and Florida eyes ICHRA innovation December 8, 2025 1. 'This litigation is a PR stunt': UnitedHealth seeks to dismiss Medicare Advantage lawsuit from Ballad Health Full story 2. Florida floats insurance…

Humana, Cuban hint at pharmacy partnership | Democrats push 'last chance' ACA subsidies | The MA question on execs' minds | NY lawmakers push for Optum probe | Cigna joins CMS health tech ecosystem

Humana and Mark Cuban hint at partnership and Senate Dems push for ACA subsidies’ last chance December 5, 2025 1. Senate Democrats push 'last chance' 3-year ACA tax credit extension Full story 2. Humana CEO, Mark Cuban hint at pharmacy partnership…

UnitedHealth resets 1 year after CEO death | Aetna shakes up prior auth | Watchdog reports ACA fraud risk | Zing sues CMS | Angle Health raises $134M

UHC shooting fallout, Aetna revamps auth and Zing challenges CMS December 4, 2025 1. One year after CEO's killing, UnitedHealth navigates a financial reset Full story 2. Aetna merges prescriptions, procedures into single prior authorization Full story 3. 83% faster…