Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
729 signals
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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.
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Mississippi revokes licenses of 59 insurance agents over ACA fraud
The Mississippi Insurance Department is revoking the licenses of 59 insurance agents accused of fraudulently selling ACA marketplace plans while living outside the state. All 59 agents were served notice of a hearing in June, but none appeared at the July 20 proceeding to dispute the allegations, according to a July 23 news release. State […] The post Mississippi revokes licenses of 59 insurance agents over ACA fraud appeared first on Becker's Payer Issues | Payer News .
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Indiana home-based Medicaid provider enrollment freeze on the horizon
Indiana Health Coverage Programs got CMS approval to progress with an enrollment and certification moratorium for some Medicaid providers beginning Aug. 1. According to a July 23 bulletin, the freeze will continue for six months. IHCP can extend the pause in six-month increments. The moratorium will target home- and community-based services 1915(c) waiver providers. Affected services include […] The post Indiana home-based Medicaid provider enrollment freeze on the horizon appeared first on B...
Policy / Regulatory Changes · 70 signals · last 30 days -
Trump Administration Issues Final Public Charge Rule And Ignores Public Comments on the Harm to Children
On July 20, 2026 the U.S. Department of Homeland Security (DHS) issued final regulations lifting current rules used to determine whether an immigrant is likely to become a “public charge”. The final rule, which takes effect on September 18, eliminates a century of established policy, carefully calibrated to address policy issues and undefined terms in […]
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Rise of uninsured patients hits CHS’ finances in Q2
Uninsured patients, largely those who dropped Affordable Care Act plans, are hitting for-profit hospital operator Community Health Systems’ bottom line harder than anticipated.
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To Afford Aging in Place, Older Adults Turn to ‘Golden Girls’ Housing
A growing network of home-sharing programs is helping people find compatible housemates. And demand is rising, driven by housing shortages, rising rents, and sales prices that affect both the old and the young.
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Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the proposed action. Int...
Policy / Regulatory Changes · 70 signals · last 30 days -
For big payers, is insurance still the point?
The country’s biggest payers have been branching out beyond insurance for years. Now, that trend is becoming even more pronounced. Second-quarter earnings have kicked off yet again, signaling how reliant these companies have become on their services units — and how much they keep investing there. UnitedHealth Group and Elevance Health reported earnings earlier this […] The post For big payers, is insurance still the point? appeared first on Becker's Payer Issues | Payer News .
UnitedHealthElevanceUnitedHealthcare + Elevance Health · 48 signals · last 30 days -
Aetna’s chief medical officer pushes back on the ‘AI bot war’
Artificial intelligence is now embedded across health insurance and care delivery operations, but Aetna’s chief medical officer says the industry still has a choice in what it does with the technology, even if early results aren’t encouraging. “AI opens the door to move at a speed and with a level of clinical engagement that’s really […] The post Aetna’s chief medical officer pushes back on the ‘AI bot war’ appeared first on Becker's Payer Issues | Payer News .
AetnaCVS Health / Aetna · 10 signals · last 30 days -
FDA panel votes to add peptides to permitted compounding list despite opposition from agency scientists
On Thursday, the Food and Drug Administration's (FDA) committee on compounded drugs broke with agency scientists and voted in favor of adding peptides to the list of substances compounding pharmacies can make, despite concerns being raised over the lack of demonstrated benefits. The FDA's Pharmacy Compounding Advisory Committee (PCAC) heard public comments and saw presentations by agency staffers concerning the peptides BPC-157, KPV, TB-500 and MOTS-c. These...
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Molina Healthcare plans more marketplace exits as ACA segment falters
Molina Healthcare is planning further reductions in its marketplace business as high costs continue to pressure that segment, the company's top brass told investors on Thursday morning.
MolinaMolina Healthcare · 1 signal · last 30 days -
HHS appeals vacatur of 2025 ACA program integrity rule
Several of the controversial provisions that were struck down reflect those of this year's annual rulemaking, which have been paused temporarily.
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New CMS data spotlight continued rise in No Surprises Act disputes
The number of out-of-network billing disputes proceeding to arbitration continues to grow, much to the consternation of health plans.
Policy / Regulatory Changes · 70 signals · last 30 days -
Molina continues to downsize exchange business
Molina Healthcare will continue to shrink its exchange business, President and CEO Joseph Zubretsky said on a July 23 earnings call. In 2026, Molina put forward average rate increases of 30% to help reduce the company’s marketplace footprint, Mr. Zubretsky said on the call. “What we can control is how much capital we’re willing to […] The post Molina continues to downsize exchange business appeared first on Becker's Payer Issues | Payer News .
MolinaMolina Healthcare · 1 signal · last 30 days -
Whistleblower alleges Cambia knowingly kept Medicare Advantage overpayments
A former employee of Cambia Health Solutions has accused the Portland, Ore.-based company of violating the False Claims Act by knowingly submitting inaccurate diagnosis data to CMS and failing to return Medicare Advantage overpayments. The whistleblower complaint, originally filed in 2020, was unsealed July 20 in a Washington state federal court. During that period, the […] The post Whistleblower alleges Cambia knowingly kept Medicare Advantage overpayments appeared first on Becker's Payer Is...
Policy / Regulatory Changes · 70 signals · last 30 days -
HHS appeals blocked exchange enrollment, eligibility rule
A federal court vacated portions of a regulation that tightened the health insurance exchange enrollment process.
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Telehealth firms urge FDA to legalize peptides, with guardrails
Hims & Hers, which owns a peptide manufacturing facility in California, has said it plans to offer peptides if U.S. regulators legalize them.
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Fragmentation is breaking healthcare reimbursement
See how healthcare organizations can prevent denials, streamline reimbursement and improve the patient financial experience through integrated revenue cycle strategies.
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Massachusetts negotiates $72M in rate reductions, rejects Fallon’s rate hike for 2027
The Massachusetts Division of Insurance has renegotiated lower rates — projecting $72 million in premium savings — with insurers in the state’s merged individual and small employer market. The negotiations included Blue Cross Blue Shield of Massachusetts HMO Blue, Harvard Pilgrim Health Care, Health New England, Mass General Brigham Health Plan, Tufts Health Public Plans, […] The post Massachusetts negotiates $72M in rate reductions, rejects Fallon’s rate hike for 2027 appeared first on Becke...
Blue Cross Blue Shield plans · 21 signals · last 30 days -
Ex-Centene vice president accuses company of age discrimination
A former vice president at Centene filed an age discrimination lawsuit against the company July 21. Kay Timmerman filed the complaint in the St. Louis County Circuit Court. The filing said Ms. Timmerman was 59 years old. In August 2025, Centene restructured some vice president roles. The document said Ms. Timmerman landed a vice president […] The post Ex-Centene vice president accuses company of age discrimination appeared first on Becker's Payer Issues | Payer News .
CenteneCentene · 11 signals · last 30 days -
Molina to pull back on exchanges as costs mount
Molina Healthcare upped its earnings guidance based on optimism about its Medicaid business.
MolinaMolina Healthcare · 1 signal · last 30 days