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Payer

Payers have faced state penalties in 2025 for slow reimbursements, improper claims denials, and mental health parity violations. Fines in 2024 are here. Payers fined by states in 2025:

Walmart has partnered with Soda Health to launch the Walmart Everyday Health Signals program, aimed at helping Medicare Advantage and Medicaid enrollees make healthier food choices through personalized guidance based on online shopping patterns. Members will receive tailored insights on…

Many insurers are asking for double-digit rate increases in 2026 for the individual and small group exchange markets as they face a potential expiration of enhanced premium tax credits and rising costs.

A federal judge has approved a $69 million agreement to settle a class-action lawsuit that alleged UnitedHealth Group prioritized its business relationship with Wells Fargo over concerns that its 401(k) plan contained low-performing target-date funds, according to court records.  Judge…

Fitch Ratings has downgraded the health insurance industry’s outlook to deteriorating from neutral because of rising utilization and Medicaid and ACA cuts proposed in Republicans’ One Big Beautiful Bill Act.  The bill was passed by the House of Representatives on…

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ICHRA adoption has grown by more than 1,000% since 2020, with employers of all sizes continuing to adopt the insurance model at double-digit growth year after year, according to the HRA Council’s annual growth trends report for the ICHRA &…

UnitedHealthcare is ending broker commission payments for some of its Medicare Advantage plans.  In a statement shared with Becker’s June 17, a spokesperson said the company will not pay commissions for new enrollments for a “small percentage” of its Medicare…

Humana’s five-year plan entails a transformation from a health services company to a consumer healthcare company, CEO Jim Rechtin told investors.  The company held its annual investor day June 16. Mr. Rechtin said the company will expand its reach within…

Medicare Advantage enrollees receive fewer home health visits than their counterparts in fee-for-service Medicare, according to the Medicare Payment and Advisory Commission.  The commission, which advises Congress on Medicare and Medicaid issues, published a report to Congress June 12.  Here…

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