June 26, 2025

1. How a Texas payer cut prior auth denials to 7% ahead of industry reform pledge Full story

2. CVS Caremark ordered to pay $95M for inflating Medicare drug prices Full story

3. CMS is cracking down on prior auth delays. What payers need to know: here.

4. Insurers lagging on customer experience, brand perception: 5 things to know Full story

5. Healthcare billing fraud: 10 recent cases Full story

 

6. DTC care is exploding. How 5 of the 7 biggest health plans are competing: here.

7. Optum launches AI marketplace Full story

8. CMS head urges PBMs to end drug rebates Full story

9. UnitedHealth Group in the headlines: 10 updates Full story

10. Only 8% of GLP-1 users stay on treatment after 3 years: Study Full story

11. Medicaid top of mind for payer execs: 15 leaders' biggest priorities Full story

 

12. The scalable AI approach that works: How this provider-sponsored health plan transformed its operations here.

Becker's Learning Opportunities

13. New evidence could cut spend & improve chronic wound outcomes. What payers should know, here.

14. Outdated UM strategies won't work with new CMS requirements. How payers are preparing for CMS-0057: here.

15. The AI agent advantage is real — and reshaping member trust. What payers should know: here.

Companies to Know
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