Payer Issues Archives - Page 9 of 177 - Becker's Payer Issues

CEO pay rises at CVS | Centene taps 2 group presidents | Elevance expanding out-of-network penalty policy to NY | BCBS urges fix to MA fraud gaps | 10 UnitedHealth updates

Elevance is expanding a controversial network policy and Centene shuffles its C-suite April 6, 2026 1. CVS Health's 6 highest-paid executives in 2025 Full story 2. Centene debuts 2 group president roles Full story 3. This fall: 500+ payer execs…

CMS finalizes MA star ratings changes | How useful is the new prior auth data? | Elevance 'ghost network' lawsuit moves forward | 15 payer leaders on adapting to policy shifts | 19 systems dropping MA plans

How useful is the new prior auth data? + CMS enacts star ratings changes in MA final rule April 3, 2026 1. CMS finalizes 2027 Medicare Advantage and Part D rule: 10 notes Full story 2. Public prior authorization data…

BCBS Texas, Memorial Hermann split | UnitedHealthcare beats web tracking suit | Feds zero in on hospital contracting | BCBS Minn. posts $353M operating loss | Anthem Blue Cross extends E/M policy pause

UnitedHealthcare beats a web tracking lawsuit and a major network split in Texas April 2, 2026 1. UnitedHealthcare beats website tracking lawsuit Full story 2. Memorial Hermann goes out of network with BCBS Texas Full story 3. Disconnected analytics hurt…

Cuban backs big insurer breakup bill | Steward trustee sues Aetna | CMS extends Elevance MA sanction deadline | 4 HSA policy updates | CareSource closes Wis. MCO deal

Steward’s trustee is suing another payer and Mark Cuban backs the big insurer breakup bill April 1, 2026 1. Mark Cuban backs bill to break up vertically integrated insurers Full story 2. Steward trustee sues Aetna, seeking $6.3M in unpaid…

Prior auth metrics go public | CareFirst names CEO | Elevance appoints 6 leaders | ACA enrollment falls, premiums rise | CVS, BCBS overcharged federal plan $615M: OIG

Payers are now required to post prior auth metrics and the average ACA premium is rising March 31, 2026 1. Payers' prior authorization denial rates go public: 5 notes Full story 2. Elevance makes 6 senior leadership appointments Full story 3.…

Elevance CEO pay rises, Centene declines | Senators push for MA upcoding oversight | 8 MA numbers to know | SCAN taps chief AI officer | 10 Cigna updates

CEO pay rises at Elevance, falls at Centene + some Senators push CMS for upcoding oversight March 30, 2026 1. Elevance Health's 5 highest-paid executives in 2025 Full story 2. Centene's 5 highest-paid executives in 2025 Full story 3. What…

Aetna, Elevance, Humana kickback case advances | 7 issues in Mount Sinai-Anthem dispute | Bill would cap insulin at $35 | HHS, CMS launch healthcare committee | UnitedHealth sued over excluded shareholder plan

Insurers, brokers to confront MA kickback allegations, and Mount Sinai and Anthem speak out March 27, 2026 1. Judge rules Aetna, Elevance, Humana must face Medicare kickback allegations Full story 2. The 7 things on the table in the Mount…

FTC nears settlement with CVS | Medicaid work rules + enrollment losses: 6 notes | ACA insurers with highest denial rates | UnitedHealthcare launches AI assistant | NY to roll back Essential Plan coverage

Who is at risk of losing Medicaid expansion coverage with work requirements and redeterminations? March 26, 2026 1. FTC nears settlement with CVS Caremark Full story 2. Medicaid work rules and enrollment losses: 6 notes Full story 3. Reduce barriers between "I…

CMS rolls out new pediatric care model | Is MA working? | Highmark's $674M operating loss | 34 healthcare orgs make Fortune's 'most innovative' list | Minn. Medicaid corrective action plan gets greenlight

CMS introduces pediatric care model and approves Minnesota’s corrective action plan for Medicaid March 25, 2026 1. CMS unveils new pediatric care model Full story 2. The Medicare Advantage paradox: Who benefits most? Full story 3. Medicaid's new era: Humana,…

Humana, CommonSpirit reach MA agreement | BCBS Minn. CEO exits Sutter board | 4 exec appointments | Bill seeks Medicare cuts for PE-owned facilities | 20 best small cities for careers

Humana and CommonSpirit wrap monthslong negotiations, and Cigna Healthcare appoints CMO March 24, 2026 1. Humana, CommonSpirit reach 3-year MA agreement, including Colorado and Texas Full story 2. BCBS Minnesota CEO leaves Sutter board over Allina deal Full story 3.…