From launching a generative AI companion to facing a lawsuit over alleged Medigap denials, here are 10 updates on UnitedHealth Group and its subsidiaries that Becker’s has reported since March 5: 1. The Louisiana Department of Health’s Medicaid contract with…
Payer
CMS has granted Elevance Health’s request for more time to resolve the ongoing dispute over Medicare Advantage risk adjustment data reporting, pushing back a possible start date on enrollment sanctions by two months. In a March 18 statement, Elevance said…
Anthem Blue Cross of California is extending the pause on its upcoming evaluation and management claim downcoding policy until at least May 1, the insurer confirmed to Becker’s March 31. The California Medical Association said the policy is pending review…
Improving the member experience is a top priority for leading health plans, yet friction across payments, regulatory compliance and system integration continues to stand in the way. The most effective approach: methodically evaluate each stage of the member journey and…
CVS Caremark and the Blue Cross Blue Shield Association overcharged the Federal Employees Health Benefits Program by a total of $615 million in pharmacy pricing between 2018 and 2021, according to a final audit report published by the Office of…
Advertisement
ACA enrollment reached 23.1 million in 2026, a 5% decrease from 2025, CMS reported March 27. While enrollment is down about 1.2 million consumers from the open enrollment period last year, 2026 enrollment is still 8% and 41% higher than…
A bipartisan group of four senators is advocating for stricter provisions under the proposed No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act to address insurer upcoding, according to a March 30 letter sent to CMS Administrator Mehmet Oz,…
Healthcare payers are under growing pressure to improve performance across cost, quality, and outcomes. Rising medical and specialty drug spend, increasing utilization, and shifting market dynamics, such as changing Medicare Advantage reimbursement models, accelerating pharmacy costs, and evolving employer expectations,…
The ground is shifting beneath the healthcare industry, and payers know it. With federal Medicaid funding under scrutiny, enhanced ACA subsidies expired, value-based care models continuing to evolve, and state legislatures moving at their own pace on everything from AI…
Seventeen Democratic Senators sent a March 26 letter to CMS Administrator Mehmet Oz, MD, criticizing a proposed ACA rule for 2027 that, they claim, “CMS’ own experts predict will kick 2 million Americans off the healthcare they have and accelerate the healthcare…