Payer Issues Archives - Page 8 of 161 - Becker's Payer Issues

Judge pauses parts of ACA rule | MA plan, DOJ settle over fraud scheme | Jefferson Health Plans posts $170M loss | Ohio system to stop accepting out-of-network patients | GLP-1s linked to lower cancer risk

August 25, 2025 1. Judge pauses parts of new ACA 'integrity' rule Full story 2. North Carolina Medicare Advantage plan settles with DOJ over identity theft scheme Full story 3. How Aetna Medicare is rethinking oncology strategy here. 4. Jefferson Health…

UnitedHealth stock whiplash | Cambia, BCBS ND to affiliate | HHS launches Medicare, Medicaid reform committee | Elevance expands food as medicine work | Highmark reports health plan pressures

August 22, 2025 1. As federal lawmakers sell UnitedHealth stock, Warren Buffet swoops in Full story 2. Cambia, BCBS North Dakota announce strategic affiliation Full story 3. Personalization without compliance risk? How some health plans are doing it: here. 4. HHS…

UnitedHealth, Elevance pull Colo. ACA plans | NY payer cutting jobs | Lowest-rated MA plans in '25 | CVS to pay $290M in false claims lawsuit | UnitedHealth forms oversight committee

August 21, 2025 1. UnitedHealth, Elevance scaling back ACA offerings in Colorado Full story 2. New York payer cutting 59 jobs Full story 3. Gaps in care slowing improvements? Embed alerts in the EHR. More info: here. 4. UnitedHealth names…

Elevance loses stars lawsuit | Judge blocks MA broker pay restrictions | Ga. places payer into receivership | Federal health plans to end gender-affirming care coverage | $2.8 billion BCBS settlement approved

August 20, 2025 1. Elevance loses $375M Medicare Advantage star ratings challenge Full story 2. Judge rules against Medicare Advantage broker pay restrictions Full story 3. Cut friction across member touchpoints — a proven personalization roadmap here. 4. Georgia payer…

Top MA plans for member satisfaction | UnitedHealth buys gastro physician group | Maine system cuts ties with Anthem | Trump revokes EO on competition | Iowa's Medicaid work rules start in '26

August 19, 2025 1. Top Medicare Advantage plans for member satisfaction in 2025: J.D. Power Full story 2. UnitedHealth's SCA Health acquires U.S. Digestive Health Full story 3. Personalization without compliance risk? How some health plans are doing it: here.…

Providence sues Kaiser over ED claims | CBO warns of $500B in Medicare cuts | BCBS Mass. posts $130M Q2 loss | Ga. fines insurers over mental health parity | 7 drugs in shortage

August 18, 2025 1. Providence sues Kaiser over ED claims Full story 2. CBO report warns of nearly $500B in potential Medicare cuts Full story 3. Medicare Advantage growth strategies: Find out what's working in markets across the nation at…

Employers expecting 10% rise in care costs | Sanford Health Plan eyes rural MA growth | Oscar, Hy-Vee launch joint plan | CMS lifts enrollment freeze on Centene plan | Aetna beats AvMed for county contract

August 15, 2025 1. Employers expect 10% rise in healthcare costs for 2026: 4 notes Full story 2. Where Sanford Health Plan's CEO is eyeing a 'significant opportunity for growth' in Medicare Advantage Full story 3. $28B in Medicare wound care…

UnitedHealth, Amedisys close merger | 'Fasten your seatbelts,' Providence Health Plan CEO says of '26 | Oracle unveils new EHR | Humana, DrFirst launch new program | Man accused of stalking slain UnitedHealthcare CEO's family

August 14, 2025 1. UnitedHealth, Amedisys complete merger Full story 2. Man accused of cyberstalking, threatening family of slain UnitedHealthcare CEO Full story 3. Real-time prior auth? Highmark, AHN & Abridge partner to cut prior auth delays from months to…

Broker sued after DOJ kickback allegations | Optum acquires another medical group | CMS' latest ACA enrollment numbers | HHS blocked from sharing Medicaid data with ICE | Priority Health talks MA sustainability

August 13, 2025 1. Investor sues Medicare Advantage broker after DOJ alleges insurer kickback scheme Full story 2. Optum acquires 200-provider medical group Full story 3. As competition intensifies and regulations evolve, payer leadership strategies must be redefined. BCBS, Cigna…

6,500 providers opt out of $2.8B BCBS settlement | Fla. payer swaps president with COO | Lawmakers question Medicare prior auth | Highmark, Abridge launch partnership | 12 UnitedHealth updates

August 12, 2025 1. Nearly 6,500 providers opt out of $2.8B BCBS settlement Full story 2. Florida payer replaces president with COO Full story 3. Prepayment review takes a proactive approach, helping payers spot and resolve issues before claims are processed—unlike…