Payer

The number of prior authorization determinations issued by Medicare Advantage insurers continued to grow in 2023, according to a new report from KFF. 

Here are 10 updates on UnitedHealth Group and its subsidiaries that Becker's has reported since Jan. 9: 

Alabama has the highest average in-network denial rate for ACA insurers, while South Dakota has the lowest, according to KFF. 

Insurers on the ACA marketplace denied around one in five in-network claims in 2023, according to a report from KFF published Jan. 27. 

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.