Humana is ramping up its efforts to reform the prior authorization process with a set of new policies that will reduce volumes for providers, speed up decisions, and increase transparency. Becker’s sat down with Caraline Coats, senior vice president for…
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Molina Healthcare reported a 15% decline in net income year over year, according to the company’s second quarter earnings posted July 23. Total revenue in the second quarter was $11.4 billion, up 16% year over year. Total net income in…
Providers are winning the majority of independent dispute resolution cases under the No Surprises Act, but recent court rulings have limited enforcement of awards and new lawsuits allege providers are misusing the IDR process for financial gain. The NSA was…
Massachusetts has rejected ACA rate proposals for 2026 from BCBS Massachusetts and WellSense Health Plan. WellSense is the insurance arm of Boston Medical Center, which requested a 16.2% rate increase for the individual and small employer market next year. BCBS…
Oscar Health is expecting to operate at a loss in 2025 as costs climb in the individual market. The company reported preliminary results for the second quarter of 2025 on July 22, expecting a loss from operations of $200 million…
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Humana is accelerating its efforts to reform the prior authorization process through a series of new policies, following the broader insurance industry’s recent pledge to reduce and streamline prior auth requirements. By January 1, 2026, Humana will eliminate one-third of…
The Medicare Part D market is facing an “uncertain future,” according to an analysis from KFF published July 16. The future of the Part D market depends on whether CMS extends the Part D premium stabilization program put in place…
ACA premiums are set to rise by 15% on average in 2026, The Wall Street Journal reported July 18. The Journal used data analyzed by KFF to report rate increases for the largest insurers in 19 states. BCBS Illinois is…
A new Alaska law takes effect on Jan. 1, 2026 that requires faster responses to prior authorization requests for certain treatments and services, the Alaska Beacon reported July 18. Under the new law, payers are required to notify patients within…
With GLP-1 medication costs being a top concern for employers heading into 2026, UnitedHealthcare is addressing the challenge through its Total Weight Support program, aimed at improving weight loss outcomes for employees while managing the costs of medication adherence. “In…