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1. CMS reinstates some ACA enrollees after cutting 760,000 people Full story
2. IRS, Treasury pitch ACA subsidy verification rule: 7 things to know Full story
3. Everything you need to know about RADV audits: Learn best practices for reducing provider abrasion, increasing validation efficiency, and selecting the strongest records for your next audit.
4. 8 things to know about 2027 Medicare Advantage star ratings Full story
5. Cigna accused of underpaying ground ambulances to boost its own fees Full story
6. Beginning in 2027, health plans get scored on what happens after a positive stool test. NCQA’s research scientist explains in this webinar.
7. Individual market enrollment drops 18% Full story
8. 31 recent payer exec moves to know Full story
9. Insurers, AMA join forces on provider directory data standard Full story
10. Blue Cross and Blue Shield of Louisiana names new CEO Full story
11. Electronic prior auth goes live Jan. 1. Will ASCs see any of it? Full story
12. Faster reviews, same defensibility? How payers are testing AI in utilization management here.
Becker’s Learning Opportunities
13. Nearly every vendor claims AI. Few can show how it reasons. How to filter real results here.
14. Your member experience is building confidence or eroding it. 3 steps to find out and act — here.
15. Value-based care promised better outcomes and lower costs. Has it delivered? Horizon BCBS New Jersey shares an honest read in this webinar.
16. Becker’s upcoming webinars: predicting drug shortages, AI in patient translation and capital planning. See the sessions here.
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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