Ten providers recently posted job listings seeking leaders in payer contracting and relations.

A Texas state judge handed a victory to system-owned health plans that missed out on Texas' Medicaid contract awards, The Dallas Morning News reported Oct. 4. 

From suing CMS over one phone call to launching its prior authorization gold-card program, here are 10 updates on UnitedHealth Group and its subsidiaries that Becker's has reported since Sept. 11:

States could better leverage Medicaid managed care organizations to promote maternal health, a report from HHS' Office of Inspector General found. 

UnitedHealthcare is expanding its individual and family ACA marketplace plans to four new states and adding 119 new counties in 13 current states for 2025.

The Senate Permanent Subcommittee on Investigations will release a "dramatic" report on Medicare Advantage in the coming weeks, Sen. Richard Blumenthal said. 

A New Jersey-based company has agreed to pay more than $11.3 million to settle False Claims Act allegations arising from fraudulently reported call center performance metrics and fraudulent claims to the South Carolina Department of Health and Human Services.

UnitedHealthcare is asking a federal court to prevent CMS from downgrading its Medicare Advantage star ratings based on one phone call. 

Centene's Ambetter Health individual plans will expand to 60 new counties in 2025. 

The USP Drug Classification PLUS is an offering from USP that provides online, interactive access to the USP Drug Classification (an independent drug classification of FDA-approved drugs, organized by categories and classes) with:

The percentage of Humana Medicare Advantage members enrolled in plans rated 4 stars or higher for 2025 has dropped significantly, which is expected to negatively affect 2026 revenues.

Blue Shield of California will purchase Fresenius Kabi's Humira biosimilar directly from the manufacturer, a deal that will cut costs and improve patient adherence, the insurer said. 

Opioid use disorder (OUD) continues to impose a financial burden on the U.S. health care system, with direct health care costs estimated at $63 billion annually. A significant portion of these costs stem from hospitalizations related to withdrawal management and other OUD-related complications. However, a promising new treatment protocol for extended-release (XR) naltrexone may offer payers an approach that not only improves patient outcomes but also reduces these substantial costs.

Elevance is planning to expand its operations in Indianapolis by investing $11.9 million in two sites in the city, Inside Indiana Business reported Sept. 30. 

Premera Blue Cross will no longer offer Medicare Advantage plans in 2025. 

In 22 states and Washington, D.C., there will be fewer Medicare Advantage plans available in 2025 than in 2024, according to CMS data. 

UnitedHealthcare's national prior authorization gold-card program went into effect Oct. 1. 

Major insurers have launched their Medicare products for 2025, offering older adults new plan options during the upcoming annual enrollment period from Oct. 15 to Dec. 7. 

GLP-1's are the No. 1 question on employers' minds when it comes to healthcare benefits, Kasey Raetz, PharmD, told Becker's. Cigna's EncircleRx program provides some answers. 

The California Department of Managed Health Care has fined Anthem Blue Cross and its Medicaid plan a total of $8.5 million for failing to address claims payment disputes in a timely manner with physicians, hospitals and providers.