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1. Whistleblower alleges Cambia knowingly kept Medicare Advantage overpayments Full story
2. Aetna’s chief medical officer pushes back on the ‘agentic bot war’ Full story
3. Cancer care gaps drive poor outcomes and avoidable costs. What payers can do: here.
4. Molina continues to downsize exchange business Full story
5. Mississippi revokes licenses of 59 insurance agents over ACA fraud Full story
6. Claims processing and care coordination weren’t built for autonomous AI. See the fix, here.
7. Massachusetts negotiates $72M in rate reductions, rejects Fallon’s rate hike for 2027 Full story
8. Democratic-led bill pitches guaranteed health coverage for children Full story
9. Indiana home-based Medicaid provider enrollment freeze on the horizon Full story
10. Payer pre-payment audits are stretching CHS’s A/R days, CFO says Full story
11. Senators Cassidy, Sanders diverge on CDC director nominee Dr. Erica Schwartz Full story
12. When the NEMT audit arrives, your health plan is the responsible party. Prepare here.
Becker’s Learning Opportunities
13. New study uncovers what separates AI leaders and laggards. Get the payer-centric data here.
14. FHIR readiness isn’t enough. Build a smarter prior authorization strategy beyond compliance here.
15. Payers cut operational costs 15-20% with integrated infrastructure. See how 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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