Payer Issues Archives - Page 7 of 177 - Becker's Payer Issues

CMS pitches extension of prior auth rule | UnitedHealthcare taps Mid-Atlantic CEO | Revenue cycle's AI arms race heats up | Blue Shield of Calif. faces care denial scrutiny | How WVU is bucking the MA retreat

April 13, 2026 1. CMS proposes extension of prior authorization rule to cover drugs: 6 notes Full story 2. UnitedHealthcare names Mid-Atlantic commercial CEO Full story 3. Chart chase workflows break down operationally. What comes next for payers here. 4.…

UnitedHealth tracks staff AI use: Report | CMS finalizes ACA overhaul: 6 notes | BCBS Mass. back in the black | Humana taps AI exec | 28 fastest-growing healthcare jobs

CMS clears path for network-free ACA plans + UnitedHealth is tracking employee AI use May 18, 2026 1. UnitedHealth tracks AI use among some staff: Report Full story 2. CMS finalizes ACA marketplace overhaul for 2027: 6 notes Full story 3.…

5 payers among Time's 'Most Impactful' | Federal healthcare fraud crackdown, explained | Ind. hospital issues Anthem 2nd breach notice | Software owner convicted in $1B Medicare fraud | CVS to sell LTC pharmacy

92% of hospital leaders expect significant Medicaid cut impact May 15, 2026 1. 5 payers land on Time's 'Most Impactful Companies' list Full story 2. Indiana hospital issues Anthem 2nd breach notice Full story 3. AI for payers starts with…

UnitedHealth, CVS, Elevance: Payers or software firms? | CMS freezes $1.3B in Calif. Medicaid funds | 29 orgs join CMS prior auth effort | More UHC members lose LVHN access | 3 payer exec moves

Federal dollars frozen, a network split and payers’ software pivot May 14, 2026 1. How AI is turning UnitedHealth, CVS and Elevance into software companies Full story 2. White House freezes $1.3B in Medicaid payments to California Full story 3.…

Healthiest, unhealthiest states for older adults: United Health | 300,000 BCBS members risk losing Mich. Med access | Cigna to face $6M COVID testing trial | CMS freezes hospice, home health enrollments | GLP-1 pivot could save state health plan millions

State rankings for older adults, and Cigna goes to trial May 13, 2026 1. The healthiest, unhealthiest states for older adults in 2026: United Health Foundation Full story 2. 300,000 in limbo as BCBS Michigan, Michigan Medicine clash over reimbursement…

Optum Rx delinks drug prices from fees | Payer Q1 profits ranked | Calif. uninsured population could double by 2030 | Trump admin pitches maternal health agenda | 10 payer fines

Inside Optum Rx’s transparency push May 12, 2026 1. 'Gone are the days': Optum Rx to delink drug prices from fees Full story 2. Payers ranked by Q1 profits Full story 3. What are leading payers doing differently in payment…

Payer CEO-to-worker pay ratios | Humana taps ex-CVS VP as data chief | Kaiser Q1 margin slips to 2.1% | Elevance subsidiary sued over MA payments | FDA chief's future uncertain

How much payer CEOs make compared to their employees, plus Humana hires a CVS alum May 11, 2026 1. Payers ranked by CEO-to-worker pay ratios Full story 2. Humana taps CVS alum as chief data, analytics officer Full story 3.…

Elevance exec fights DOJ deposition | The latest on prior auth reform | UnitedHealthcare paying some claims in real time | A new AI threat: Fake medical records | 7 drugs in shortage

An Elevance exec fights a DOJ interview bid + breaking down the latest on prior auth reform May 8, 2026 1. Elevance senior executive fights DOJ deposition bid in Medicare Advantage fraud case Full story 2. What's the latest on…

Payer exiting MA in 24 days | MA pressure, prior auth reform and AI consume payers' Q1 | Oscar launches ICHRA data exchange | Insurers' 'direct-to-consumer' push: 5 notes | Federal vs. state payer AI rules

A sudden Medicare Advantage exit + MA, prior auth and AI consume payers’ Q1 May 7, 2026 1. Illinois payer to shutter Medicare Advantage business in 24 days Full story 2. 'The status quo is unsustainable': MA pressures, prior auth…

CVS posts $2.9B Q1 profit | Highmark hires senior UnitedHealth exec | CMS fines 13 payers | Oscar enrollment, profits jump | Broward Health sues Florida Blue

CVS is boosting its earnings guidance and Highmark nabs an industry leader May 6, 2026 1. CVS reports $2.9B Q1 profit as Aetna strengthens Full story 2. Highmark Health taps senior UnitedHealth exec as COO Full story 3. When AI guides care…