Payer

CMS proposed a payment bump for Medicare Advantage plans in 2026, and insurers are continuing to file challenges over star ratings. 

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.

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'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.

Almost every state has completed the unwinding of Medicaid continuous coverage, but the process is still causing problems for insurers. 

An Indiana lawmaker has reintroduced legislation that would cap all prior authorization rates at 1%, the Indiana Capital Journal reported Jan. 23. 

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 Health posted nearly $6 billion in net income in 2024, according to the company's year-end earnings report published Jan. 23.

CMS has withdrawn its appeal of a judge's decision directing the agency to increase UnitedHealthcare's star ratings for its Medicare Advantage plans for 2025. 

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.