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1. CMS appeals Clover’s Medicare Advantage star ratings win Full story
2. Insurer pricing, claims data transparency bills advance in Congress: What to know Full story
3. Becker’s Fall Payer Issues Roundtable convenes 500+ payer executives, 85+ speakers, and a keynote from Emmitt Smith. Two days in Chicago, Nov. 2-3, that close out the year for payer strategy. Apply to attend as a reviewer here.
4. No Surprises arbitration payouts hit $15B in 2025 alone: WSJ Full story
5. Ex-Centene vice president accuses company of age discrimination Full story
6. CMS is removing 11 star rating measures — what it means for quality performance + how to protect it here.
7. Cigna aims to save $200M in 3 years by expanding AI-enabled care management Full story
8. Molina raises earnings guidance as profits drop 76% in Q2 Full story
9. Henry Ford Health sues CVS, alleges 340B pricing scheme Full story
10. GLP-1 use overtakes bariatric surgery in youth: 4 study notes Full story
11. 6 new drugs in shortage Full story
12. 92% of insurers have AI budgets. What’s turning spend into impact here.
Becker’s Learning Opportunities
13. Every 4-week delay raises cancer mortality risk 6–8%. See how payers reduce delays here.
14. EMR data overload slows utilization review. More efficiency in highlighting what matters here.
15. The plans improving their Star Ratings aren’t buying more tools. See what they are doing here.
16. Becker’s resources don’t stop here — explore more webinars and whitepapers.
Apply to attend complimentary as a guest reviewer here! Opportunity exclusive to those directly employed by a payer, payvider, accountable care organization, or clinically integrated network.
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