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1. Humana’s Villages Health to pay $541.5M to settle Medicare Advantage fraud allegations Full story
2. $10M from Florida’s Centene Medicaid settlement misappropriated by DeSantis administration: Report Full story
3. GLP-1s are reshaping pharmacy economics for every health plan, ICHRA is changing the employer-sponsored market, and direct contracting is shifting the network model. All three are on the agenda Nov. 2-3 in Chicago. Apply to attend Becker’s Fall Payer Issues Roundtable as a reviewer here.
4. New Jersey man sentenced in $50M insurance fraud scheme Full story
5. GuideWell taps Cigna exec for CFO role Full story
6. AI agents are eliminating the tradeoff between audit quality and scale. Learn how during this webinar. Register with one click.
7. Oklahoma places ACA insurer Mending Health under state supervision Full story
8. 6 things to know about employers’ GLP-1 cost strategy Full story
9. Arizona failed to ensure Medicaid insurers followed mental health parity rules: OIG Full story
10. 34% of Americans use AI chatbots for health: Report Full story
11. From -4.8% to 26.7%: 25 large systems ranked by Q2 margins Full story
12. How Highmark turned employer reporting into a driver of renewals and growth here.
Becker’s Learning Opportunities
13. A cancer misdiagnosis caught early saved one plan $174,000. See how here.
14. How much specialty pharmacy revenue slips through denials & prior auth delays? Register for the webinar to find out.
15. Blood tests for cancer and Alzheimer’s are arriving faster than plans can vet them. Details here.
16. Becker’s late-August webinar lineup: patient safety, referral intake, AI trust and supply chain data. 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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