Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
724 signals
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4 more Medicare Advantage contracts get 5 stars in revised ratings
Four more Medicare Advantage prescription drug plans have received five-star ratings thanks to CMS’ recalculation. CMS initially unveiled 2026 MA star ratings in October, with 18 MA-PD contracts scoring five stars overall. On July 22, CMS released updated 2026 Medicare Advantage star ratings. The recalculation comes in the fallout of Clover Health’s lawsuit challenging the […] The post 4 more Medicare Advantage contracts get 5 stars in revised ratings appeared first on Becker's Payer Issues |...
Clover Health -
5 health system vs. payer lawsuits to watch
Providers are suing insurers over what they describe as systematic underpayment and unilateral policy changes that reduce reimbursement, while insurers have been turning to the courts to accuse hospitals of gaming the No Surprises Act’s arbitration process. Layered on top are antitrust cases targeting the pricing vendors and market structures that determine what gets paid. […] The post 5 health system vs. payer lawsuits to watch appeared first on Becker's Payer Issues | Payer News .
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Philips earnings beat estimates with boost from US tariff refund
A U.S. tariff refund contributed to the margin beat alongside strong demand for medical scanners.
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Medicare Advantage enrollment share to reach 57% by 2036: CBO
Medicare Advantage will account for 57% of overall Medicare enrollment by 2036, up from 51% this year, according to a July report from the Congressional Budget Office. Five things to know: The post Medicare Advantage enrollment share to reach 57% by 2036: CBO appeared first on Becker's Payer Issues | Payer News .
Membership Movement · 5 signals · last 30 days -
8 things to know about healthcare spending trends
More data is pointing to concerns of skyrocketing healthcare costs in the upcoming years. Steeper medical utilization is one cause for concern, according to several sources. Meanwhile, HR 1 is radically reshaping Medicaid, and the expiration of ACA enhanced subsidies risk more people going uninsured. Here are eight things to know about U.S. healthcare spending: […] The post 8 things to know about healthcare spending trends appeared first on Becker's Payer Issues | Payer News .
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CMS Issues New Rule Again Going Beyond H.R. 1 Requirements to Further Restrict State Use of Medicaid Provider Taxes
On July 21, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a new proposed rule that would implement two of H.R. 1’s restrictions on states’ use of provider taxes to finance their share of Medicaid costs. H.R. 1 included three provider tax restrictions: (1) a prohibition on new provider taxes and increases in […]
Policy / Regulatory Changes · 68 signals · last 30 days -
Previous vaccinations shouldn’t bar worker’s religious vaccine exemption request, 9th Circuit says
The update is the latest in a COVID-19 vaccine mandate case brought by a former consultant against Kaiser Permanente's medical group.
KaiserKaiser Permanente · 5 signals · last 30 days -
Electronic Prior Authorization Arrives Jan. 1, 2027: What Hospitals Need to Know
As major provisions of the 2024 Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization final rule take effect next year, hospitals and health systems should begin preparing for changes to prior authorization workflows, payer interactions and information exchange.On Jan. 1, 2027, many of the most significant provisions of the 2024 CMS Interoperability and Prior Authorization final rule will take effect for impacted Medicare Advantage organizations, Medicaid man...
Policy / Regulatory Changes · 68 signals · last 30 days -
Excellus BCBS to face former director’s racial discrimination allegation
Excellus BlueCross BlueShield must face claims of race discrimination and retaliation brought by a former contract negotiation director, according to a July 22 federal court order. U.S. District Court Judge Anthony Brindisi denied Excellus’ motion for summary judgment and allowed those claims, as well as a state gender discrimination claim, to move to trial. The […] The post Excellus BCBS to face former director’s racial discrimination allegation appeared first on Becker's Payer Issues | Paye...
BCBSBlue Cross Blue Shield plans · 20 signals · last 30 days -
Oregon lifts supervision order on Medicare Advantage insurer
Oregon regulators have released ATRIO Health Plans from state supervision three months after finding the Medicare Advantage insurer was in a “hazardous financial condition.” The Oregon Division of Financial Regulation terminated the supervision July 14, saying the conditions that prompted the order no longer exist and that the company had taken steps to significantly improve […] The post Oregon lifts supervision order on Medicare Advantage insurer appeared first on Becker's Payer Issues | Pay...
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Why CMS’ Medicare enrollment crackdown is alarming providers
The Centers for Medicare and Medicaid Services says limits on Medicare provider enrollment are needed to prevent fraud.
Policy / Regulatory Changes · 68 signals · last 30 days -
Strengthening Care Delivery Using Lessons from Veterinary Health
Healthcare leaders can improve trust, collaboration and patient outcomes by applying three proven principles from veterinary medicine to care delivery.
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Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-April Through June 2026
This quarterly notice lists Centers for Medicare & Medicaid Services (CMS) manual instructions, substantive and interpretive regulations, and other Federal Register notices that were published in the 3-month period, relating to the Medicare and Medicaid programs and other programs administered by CMS.
Policy / Regulatory Changes · 68 signals · last 30 days -
Medicare Program; Approved Renewal of Deeming Authority of the National Committee for Quality Assurance (NCQA) for Medicare Advantage Health Maintenance Organizations and Preferred Provider Organizations
This notice announces our decision to approve the National Committee for Quality Assurance's renewal application for Medicare Advantage "deeming authority" of Health Maintenance Organizations and Preferred Provider Organizations for a term of 6 years.
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Jefferson Health sues Independence Blue Cross over nearly $100M in disputed payments
Jefferson Health is alleging Independence Blue Cross used a string of reimbursement policy changes this year to cut what it pays the health system by an amount approaching $100 million in a new lawsuit. The July 22 complaint, filed in Philadelphia’s Court of Common Pleas, laid out five policy shifts the health system says breach […] The post Jefferson Health sues Independence Blue Cross over nearly $100M in disputed payments appeared first on Becker's Payer Issues | Payer News .
Blue CrossBlue Cross Blue Shield plans · 20 signals · last 30 days -
What's behind Aetna's investments to build provider trust
Addressing healthcare's biggest challenges will require payers and providers working together.
AetnaCVS Health / Aetna · 10 signals · last 30 days -
Industry Voices—The new model for rural healthcare is already taking shape
Community health plans are uniquely positioned to bring together technology and community partnerships to address local rural care needs, writes Tom Doran, president of Highmark Health Plan.
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Tenet Healthcare shrugs off ACA headwinds with sweeping Q2 outperformance, boosts 2026 guidance
Bucking a trend set by its for-profit peers, the company outpaced the margin hit of substantial uninsured volume growth and boosted its 2026 guidance.
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New university initiative offers screening, referrals for endometriosis
The partnership, led by a national provider of endometriosis care and an awareness nonprofit, offers colleges free educational resources, screening tools and referral pathways.
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HHS appeals decision vacating provisions of 2025 ACA marketplace rule
HHS and CMS appealed a Maryland federal court’s decision to vacate parts of CMS’ 2025 “Marketplace Integrity and Affordability Rule,” according to July court filings. In the Columbus I case — which has the city governments of Columbus (Ohio), Baltimore and Chicago, as well as other groups, as plaintiffs — the Maryland district court ruled on summary judgment in June […] The post HHS appeals decision vacating provisions of 2025 ACA marketplace rule appeared first on Becker's Payer Issues | Pay...
Policy / Regulatory Changes · 68 signals · last 30 days -
HCA Healthcare's H1 ACA volume dropoffs 'almost one for one' shifted to uninsurance
The for-profit health system's executives said the number of patients who dropped health insurance exchanges were within expectations, but that they were surprised almost none of those patients shifted to commercial coverage.
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5 payers entering ACA markets in 2027
There will be at least five new carriers on ACA marketplaces in 2027, despite the continued pressures facing the wider market. Nationally, insurers have proposed a median 14% rate increase for 2027, the second straight year of double digit hikes. Total marketplace enrollment stood at nearly 19.2 million in February, down 12% from nearly 21.8 […] The post 5 payers entering ACA markets in 2027 appeared first on Becker's Payer Issues | Payer News .
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MAP: States report new measles cases as virus surpasses alarming benchmark
Cyclospora isn't the only public health crisis the U.S. is contending with in 2026. Measles, one of the world's most contagious viruses, has now spread to 43 states, the Centers for Disease Control and Prevention said on Friday.
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ICYMI: Chairman Smith Issues Subpoenas to CCP-Linked Singham Network Nonprofits After Their Refusal to Comply with Committee Oversight
WASHINGTON, D.C. – House Ways and Means Committee Chairman Jason Smith (MO-08) announced the Committee has issued subpoenas to BreakThrough News,... The post ICYMI: Chairman Smith Issues Subpoenas to CCP-Linked Singham Network Nonprofits After Their Refusal to Comply with Committee Oversight appeared first on Ways and Means .
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GE HealthCare finance chief departs unexpectedly while company posts revenue growth
The Chicago-based imaging giant tempered the unexpected CFO news with a peek at revenues that are expected to come in higher than previously expected.