Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
1208 signals
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Cigna Group, OpenAI team up to support patients with complex conditions
Cigna is teaming up with OpenAI to build out more personalized supports for individuals with complex conditions, starting with a focus on cancer patients.
CignaCigna · 15 signals · last 30 days -
Trump Administration Announces $13 Million Investment to Expand Behavioral Healthcare and Create a 24/7 Mobile Crisis Response Service in South Dakota
Trump Administration Announces $13 Million Investment to Expand Behavioral Healthcare and Create a 24/7 Mobile Crisis Response Service in South Dakota This federal investment will expand provider capacity, modernize IT infrastructure, and strengthen the behavioral healthcare workforce across South Dakota The Trump Administration announced today that a $13 million investment is being delivered to create a same-day 24/7 mobile crisis response service for South Dakota residents in need of critic...
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Penn Medicine, IBX plan 18+ surgery centers
Penn Medicine, Independence Blue Cross and Regent Surgical have partnered to develop at least 18 ASCs. The three organizations will form a new company to run the centers, which will be located across Penn Medicine’s service area in Pennsylvania, New Jersey and Delaware. The timing, scope and economic impact of the ASCs will depend on […] The post Penn Medicine, IBX plan 18+ surgery centers appeared first on Becker's Payer Issues | Payer News .
Blue Cross Blue Shield plans · 37 signals · last 30 days -
Centene executive exits pile up in 2026
In 2026, Centene’s leadership has turned over at many levels, from state health plan executives to the C-suite. The insurer ended 2025 with a 91.9% medical loss ratio and a $6.7 billion loss. That loss was mainly driven by a $6.7 billion non-cash goodwill impairment, spurred by HR 1 and a drop in the company’s […] The post Centene executive exits pile up in 2026 appeared first on Becker's Payer Issues | Payer News .
CenteneCentene · 13 signals · last 30 days -
Clover adds former US senator, MedPAC commissioner to board
Former U.S. Sen. Robert Torricelli, D-N.J., and Brian Miller, MD, have been appointed to Clover Health’s board of directors, the company shared Sept. 24. Mr. Torricelli will serve on Clover’s audit committee, while Dr. Miller will be on the clinical committee. Mr. Torricelli has been a director of Clover’s insurance subsidiaries since 2022. He founded […] The post Clover adds former US senator, MedPAC commissioner to board appeared first on Becker's Payer Issues | Payer News .
Clover HealthClover Health · 2 signals · last 30 days -
Hospitals say they’re losing the AI billing war. A new BCBS study suggests otherwise
The Blue Cross Blue Shield Association has put out a second round of research estimating that hospitals’ growing use of AI-assisted billing tools has added roughly $942 million in excess costs to the BCBS system over two years, contributing new data to the contentious “AI bot war” that’s been playing out across the industry. The […] The post Hospitals say they’re losing the AI billing war. A new BCBS study suggests otherwise appeared first on Becker's Payer Issues | Payer News .
Blue CrossBlue ShieldBlue Cross Blue Shield plans · 37 signals · last 30 days -
Oscar employees in Florida to transition to CHOICE arrangements
Oscar Health is moving its Florida-based employees from traditional group medical plans to Custom Health Option and Individual Care Expense arrangements — formerly known as individual coverage health reimbursement arrangements — in 2027. The company confirmed the move, called CHOICE 4 Oscar, to Becker’s on Sept. 24, adding the Florida transition “is the first step […] The post Oscar employees in Florida to transition to CHOICE arrangements appeared first on Becker's Payer Issues | Payer News .
Oscar Health FloridaOscar Health · 2 signals · last 30 days -
Autism Speaks chair, managed care plans up on next ABA task force agenda
A Florida task force that could reshape how the state provides therapy to children with special needs and autism is getting together again. The state’s applied behavior analysis (ABA) task force meets Monday and will consider testimony from a managed care panel that includes representatives from Simply Healthcare, Sunshine Health, and Humana Healthy Horizons. It […]
Humana FloridaHumana · 14 signals · last 30 days -
As vertical integration scrutiny grows, UnitedHealth takes center stage
“UnitedHealth Group should not be allowed to exist in the form that it currently does.” That was late-night TV host John Oliver’s verdict in his Sept. 20 episode on the inner workings of UnitedHealth Group, digging into a dramatic multi-year saga for the company that’s included a massive cyberattack, a sharp earnings decline and the […] The post As vertical integration scrutiny grows, UnitedHealth takes center stage appeared first on Becker's Payer Issues | Payer News .
UnitedHealthUnitedHealthcare · 48 signals · last 30 days -
SCAN expands into Oregon by partnering with assisted-living organization
SCAN Health Plan is expanding into Oregon through a partnership with The Springs Living, an independent-living, assisted-living and memory care provider for older adults. The expansion brings the Medicare Advantage insurer into Oregon’s Clackamas and Washington counties. SCAN and The Springs Living will also launch co-branded products available Jan. 1. “The future of healthcare for […] The post SCAN expands into Oregon by partnering with assisted-living organization appeared first on Becker's...
SCAN Health Plan · 14 signals · last 30 days -
UnitedHealth’s home health arm hit by phone phishing breach
LHC Group, a home health and hospice provider owned by UnitedHealth Group’s Optum, has disclosed a data breach tied to a vishing attack that exposed patient information. LHC Group said it became aware April 7 that an employee may have fallen victim to a voice phishing scheme, according to the September notice. The company’s third-party […] The post UnitedHealth’s home health arm hit by phone phishing breach appeared first on Becker's Payer Issues | Payer News .
UnitedHealthOptumUnitedHealthcare · 48 signals · last 30 days -
Cigna, Baptist forge multiyear agreement following June cutoff
Jacksonville, Fla.-based Baptist Health and Cigna Healthcare announced a multiyear agreement Sept. 23 after the health system went out of network in June. Effective immediately, the agreement restores in-network access to providers, clinics and hospitals. A Baptist news release said the agreement includes Wolfson Children’s Hospital. “Throughout these discussions, both Baptist Health and Cigna Healthcare […] The post Cigna, Baptist forge multiyear agreement following June cutoff appeared firs...
CignaCigna · 15 signals · last 30 days -
Cigna partners with OpenAI, starting with oncology
The Cigna Group is partnering with OpenAI to integrate AI into clinical workflows, with a first focus on cancer care. Under the collaboration announced Sept. 23, OpenAI’s tools will be built into workflows across Accredo Specialty Pharmacy and the insurance business, Cigna Healthcare. The first new capability will give oncology nurses and case managers an […] The post Cigna partners with OpenAI, starting with oncology appeared first on Becker's Payer Issues | Payer News .
CignaCigna · 15 signals · last 30 days -
UnitedHealth introduces chief administrative officer role
UnitedHealth Group tapped Jodee Kozlak to fill the company’s new chief administrative officer role, effective Sept. 28. The position focuses on enterprise modernization and alignment, initially spanning people, real estate, procurement and corporate security. Ms. Kozlak was an Alibaba Group global senior vice president from 2016 to 2017, facilitating expansion beyond China. She also served […] The post UnitedHealth introduces chief administrative officer role appeared first on Becker's Payer...
UnitedHealthUnitedHealthcare · 48 signals · last 30 days -
AI will inflate healthcare costs before lowering them, Oz says
AI will “turbocharge” medical billing and drive up costs in the short term, CMS Administrator Dr. Mehmet Oz warned Wednesday. But he said the pain is worth it for long-term savings.
Policy / Regulatory Changes · 142 signals · last 30 days -
UnitedHealth names first chief administrative officer
Jodee Kozlak, a veteran of major multinational corporations, will join UnitedHealth this coming Monday to modernize and align the healthcare behemoth’s operations across its various businesses.
UnitedHealthUnitedHealthcare · 48 signals · last 30 days -
Private Health Insurance: Federal and State Oversight of Contraceptive Coverage Requirements
What GAO Found In 2024, about 82 percent of women of reproductive age reported using some form of contraception in the past 12 months, according to research from KFF. Most private health plans are generally required to cover the full range of contraceptives for women. The Department of Labor (DOL), the Centers for Medicare & Medicaid Services (CMS)—an agency within the Department of Health and Human Services—and states each have responsibilities for overseeing private health plans, including...
Policy / Regulatory Changes · 142 signals · last 30 days -
Request for Information; Medicare Part D Reasonable and Relevant Pharmacy Contracting Standards
This request for information (RFI) solicits input from interested parties for purposes of establishing standards for reasonable and relevant pharmacy contract terms and conditions under the Medicare prescription drug benefit. Section 6223(a) of the Consolidated Appropriations Act, 2026 (CAA, 2026) amends section 1860D- 4(b)(1)(A) of the Social Security Act (the Act) to require Part D plan sponsors to permit any pharmacy that meets standard contract terms and conditions under the plan to parti...
Policy / Regulatory Changes · 142 signals · last 30 days -
UnitedHealthcare, Cigna, Centene sign on to CertifyOS' new provider credentialing model
Health tech company CertifyOS is launching a new national model for provider credentialing, with several major payers already on board as participants.
UnitedHealthcareCignaUnitedHealthcare + Cigna · 61 signals · last 30 days -
The high cost of health care guesswork, and how to address it
As costs continue to rise and visibility around health care choices remains clouded, employers are rethinking how their health plans work. Blue Cross Blue Shield of Massachusetts looks at the shift toward cost and quality transparency, and where its new plan, Beacon Blue, fits into that picture.
Blue Cross Blue Shield plans · 37 signals · last 30 days -
UnitedHealthcare, Cigna, Centene join national shared provider credentialing program
UnitedHealthcare, Cigna and Centene are among the initial participants in a national shared provider credentialing program, launching in the fall. CertifyOS, a provider data intelligence company, announced the program Sept. 23. The initiative aims to standardize credentialing and verification, speed up the time to join an insurance network and serve as a reliable source of […] The post UnitedHealthcare, Cigna, Centene join national shared provider credentialing program appeared first on Becke...
UnitedHealthcareCignaUnitedHealthcare + Cigna · 61 signals · last 30 days -
CVS, UnitedHealth, Kaiser challenge proposed Medicare remote monitoring restrictions
Health systems are not the only groups pushing back against a CMS proposal to restrict remote patient monitoring. In July, CMS pitched banning Medicare payments for remote patient monitoring services carried out by third-party companies. As proposed, starting Jan. 1, 2027, payments for remote physiologic and therapeutic monitoring would be permitted only when furnished by […] The post CVS, UnitedHealth, Kaiser challenge proposed Medicare remote monitoring restrictions appeared first on Becker...
UnitedHealthKaiserUnitedHealthcare + Kaiser Permanente · 51 signals · last 30 days -
Humana’s Medicare Part D president exits
TJ Gibb, Humana’s Medicare Part D president, has left the company through its early retirement program. In a Sept. 23 LinkedIn post, Mr. Gibb said he had been with the company for more than two decades, spending the most recent eight years leading Medicare Part D. Mr. Gibb said he is now open to board […] The post Humana’s Medicare Part D president exits appeared first on Becker's Payer Issues | Payer News .
HumanaHumana · 14 signals · last 30 days -
Centene hires AI ethicist
Centene has hired Steven Kelts for the role of AI ethicist, he announced in a September LinkedIn post. In the new role, Mr. Kelts said he is implementing ethical decision-making frameworks across the insurer’s workforce of more than 60,000 employees and is working with a team to build AI governance standards. “AI will spark a […] The post Centene hires AI ethicist appeared first on Becker's Payer Issues | Payer News .
CenteneCentene · 13 signals · last 30 days -
Oz: Medicare Advantage a garden ‘vulnerable to weeds and overgrowth’
The CMS administrator’s comments Tuesday at an event hosted by an MA lobby suggest that the Trump administration remains interested in tougher oversight of the program, despite watering down or scrapping some of its biggest proposed reforms.
Policy / Regulatory Changes · 142 signals · last 30 days