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TeamHealth physicians sue BCBS Texas over emergency care reimbursement
Three TeamHealth-affiliated physician groups have filed a lawsuit against Blue Cross and Blue Shield of Texas, alleging that the insurer breached its contract by improperly reducing reimbursements for emergency services. -
Cigna to spend $150M on patient experience: 10 notes
The Cigna Group will invest in making prior authorization faster and simpler in 2025, CEO David Cordani said. -
Rhode Island bill takes aim at prior authorization
Rhode Island lawmakers have introduced legislation that would prohibit payers from requiring prior authorization for treatment or services ordered by a patient's primary care provider. -
5 recent UnitedHealth settlements
From preliminary approvals to agreements with the federal government, these are five recent legal settlements involving UnitedHealth Group and its subsidiaries. -
UnitedHealthcare settles proton beam therapy coverage lawsuits
UnitedHealthcare has reached a settlement to resolve three proposed class action lawsuits alleging that the insurer wrongfully denied coverage for a specialized cancer treatment that plaintiffs claim is more effective but significantly more expensive than traditional radiation therapy. -
Medicare Advantage prior authorization rates keep climbing: 10 things to know
The number of prior authorization determinations issued by Medicare Advantage insurers continued to grow in 2023, according to a new report from KFF. -
UnitedHealth Group in the headlines: 10 updates
Here are 10 updates on UnitedHealth Group and its subsidiaries that Becker's has reported since Jan. 9: -
States ranked by average ACA claim denial rates
Alabama has the highest average in-network denial rate for ACA insurers, while South Dakota has the lowest, according to KFF. -
ACA insurers ranked by claim denial rates
Insurers on the ACA marketplace denied around one in five in-network claims in 2023, according to a report from KFF published Jan. 27. -
Medicare Advantage in the headlines: 7 recent updates
CMS proposed a payment bump for Medicare Advantage plans in 2026, and insurers are continuing to file challenges over star ratings. -
Judge gives initial OK to UnitedHealth's $69M 401(k) settlement
A Minnesota federal judge has given preliminary approval to UnitedHealth's agreement to pay $69 million to settle a class-action lawsuit alleging the company prioritized its business relationship with Wells Fargo over concerns that its 401(k) plan contained low-performing target-date funds. -
Unrelenting 'cost surge' at BCBS Vermont: CEO
Blue Cross and Blue Shield of Vermont is sounding the alarm about the escalating financial challenges facing the state's healthcare system, noting that "the cost surge was unrelenting through 2024." -
Colorado to limit weight loss drug coverage for employees
Colorado's employee health plan will drop coverage in July for GLP-1s prescribed to treat obesity in an effort to cut costs, the Colorado Sun reported Jan. 23. -
Medicaid challenges for payers persist in 2025
Almost every state has completed the unwinding of Medicaid continuous coverage, but the process is still causing problems for insurers. -
Indiana bill puts prior authorization in the crosshairs
An Indiana lawmaker has reintroduced legislation that would cap all prior authorization rates at 1%, the Indiana Capital Journal reported Jan. 23. -
2026 Medicare Advantage rates 'inadequate,' Elevance execs say
CMS' proposed Medicare Advantage rates for 2026 are moving in the right direction, but still "insufficient" to cover rising costs in the program, according to Elevance Health executives. -
Elevance posts $6B profit in 2024
Elevance Health posted nearly $6 billion in net income in 2024, according to the company's year-end earnings report published Jan. 23. -
CMS withdraws appeal in UnitedHealth star ratings challenge
CMS has withdrawn its appeal of a judge's decision directing the agency to increase UnitedHealthcare's star ratings for its Medicare Advantage plans for 2025. -
Inland Empire Health Plan's big growth in 2024: 6 notes
In 2024, Inland Empire Health Plan achieved significant growth through the expansion of healthcare facilities, recognition on top industry rankings, strengthened partnerships with local and community organizations, and an expanded product portfolio, according to the organization's 2025 Annual Quality Report. -
What 6 payer execs are most excited about for 2025
In 2025, health insurance leaders are focused on leveraging technology, particularly AI, to enhance healthcare delivery, expand access, address system complexities, and advance value-based care, while expanding their footprints to improve member experience and streamline operations.
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