Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
729 signals
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A father’s mission to save his daughter, and allegations on telehealth GLP-1 prescribing
Has a wanted fugitive been posing as a biotech executive? And what does it take to develop a therapy for an ultra-rare disease? Find out on this week's episode of…
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Cigna sets quarterly dividend
The Cigna Group’s board of directors July 22 declared a per-share cash dividend of $1.56 to be paid on Sept. 23. The dividend will be paid to shareholders of record as of the close of business on Sept. 8. The company will release its second quarter financial report on July 30. Cigna recorded a $1.7 […] The post Cigna sets quarterly dividend appeared first on Becker's Payer Issues | Payer News .
CignaCigna · 10 signals · last 30 days -
CMS issues implementation guidance following federal court injunction involving 2027 notice of benefit and payment parameters final rule
The Centers for Medicare & Medicaid Services July 22 released implementation guidance following a district court ruling July 16 that enjoined eight provisions from its 2027 notice of benefit and payment parameters final rule, which were set to become effective July 20. The rule issues standards for qualified health plans offered through the health insurance marketplaces. “Accordingly, for plan year 2026, Exchanges must immediately begin to update their systems to stop removing or denying adva...
Policy / Regulatory Changes · 70 signals · last 30 days -
Cigna expands AI-powered care management programs for members
Cigna Healthcare is taking steps to significantly expand its personalized care management programs, leaning on AI to identify risks sooner and simplify the patient journey.
CignaCigna · 10 signals · last 30 days -
Prosper Medical banks $16M to scale AI-driven concierge care platform
Artificial intelligence-driven health platform Prosper Medical secured $16 million in seed funding to make concierge medicine more accessible through scaling its AI-powered platform.
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Anterior, Stellarus enter strategic partnership to speed up AI-driven prior authorizations
The companies say providers will receive quicker, first-time approvals through the partnership, ultimately giving members quicker care access.
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Molina plans additional ACA cuts in 2027
Molina’s second quarter was complicated, with stability in Medicaid and outperformance in Medicare Advantage overshadowed by problems in the ACA exchanges. The trend was “unfortunate,” according to the insurer’s CEO.
MolinaMolina Healthcare · 1 signal · last 30 days -
Cigna aims to save $200M in 3 years by expanding AI-enabled care management
Cigna Healthcare estimates $200 million in medical cost reductions over three years by enhancing its care management programs with expanded AI-enabled capabilities. In a July 23 news release, the insurer aims to reach roughly 20% more customers with complex or chronic health needs — such as cancer, high-risk pregnancy or behavioral health conditions — with […] The post Cigna aims to save $200M in 3 years by expanding AI-enabled care management appeared first on Becker's Payer Issues | Payer N...
CignaCigna · 10 signals · last 30 days -
No Surprises disputes continue to swell, CMS finds
Providers and payers initiated 16% more disputes in the second half of 2025 compared with the first half, according to new federal data. But arbiters are closing challenges more quickly and tackling a backlog of disputes.
Policy / Regulatory Changes · 70 signals · last 30 days -
CMS stars redo lifts big Medicare Advantage insurers
UnitedHealthcare, Humana and Aetna are among the insurers that secured larger Medicare Advantage quality bonuses.
UnitedHealthcareHumanaUnitedHealthcare + Humana · 51 signals · last 30 days -
Slew of health bills clear key hurdles toward passage
Measures on transparency, prior authorizations and pharmacy benefit managers have strong chances of becoming law after attracting broad support.
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CMS appeals Clover MA stars lawsuit
Tuesday’s appeal is the latest development in Clover’s legal saga to get the CMS to recalculate its Medicare Advantage star ratings.
Policy / Regulatory Changes · 70 signals · last 30 days -
Va. hospitals predict $31B reduction in state’s Medicaid funding if proposed CMS rule passes
A proposed federal rule stemming from the reconciliation bill Congress passed last summer includes additional policy changes that would reduce Medicaid payments to healthcare facilities, a step hospital chains warn exceeds the provision Congress approved and President Donald Trump signed. Public comment closed this week on a rule proposed by the Centers for Medicare and […]
Policy / Regulatory Changes · 70 signals · last 30 days -
Opinion: New billing codes likely to raise maternity care costs
“This change is likely to lead to only modest increases in total medical expenses. However, it coincides with many other factors raising health insurance premiums,” writes Jeff Levin-Scherz.
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Army Corps of Engineers: Stakeholders and Corps Views on Legal Protections in Project Partnership Agreements
What GAO Found The U.S. Army Corps of Engineers enters into Project Partnership Agreements (PPA) with nonfederal sponsors to execute water resources projects. These PPAs include a clause to “hold and save the Government from damages arising from the project” except those due to the fault or negligence of the U.S. or its contractors. Corps officials said the clause may protect the federal government from legal costs by discouraging litigation—a key advantage. Nonfederal sponsors described disa...
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Combating Fraud: Managing Risks in Federally Funded, State-Administered Programs
What GAO Found Twenty programs, supporting a broad range of services from health care to disaster assistance, made up nearly 90 percent of federal obligations among programs administered by state and other government entities with obligations of over $100 million in fiscal year 2025. The 20 programs collectively accounted for $1.1 trillion in total federal obligations that year. Subrecipients, contractors, and others can also be involved in these programs, which can be helpful in delivering b...
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Notice of Public Data Asset Release Under the Open, Public, Electronic, and Necessary (OPEN) Government Data Act
In accordance with Title II of the Foundations for Evidence- Based Policymaking Act of 2018, known as the Open, Public, Electronic, and Necessary (OPEN) Government Data Act, CMS announces the forthcoming release of public data assets in open, machine-readable formats under an open license. These data are intended to support public engagement in identifying and preventing fraud, waste, and abuse, and to promote transparency and accountability. CMS has taken steps to ensure that the release of...
Policy / Regulatory Changes · 70 signals · last 30 days -
ICYMI: Chairman Guthrie Joins Fox Business Network to talk AI Policy and the Ratepayer Protection Act
**WASHINGTON, D.C.** - This week, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, [joined](https://youtu.be/nFGHYbPdTYY) _Fox Business'_ "The Bottom Line" to discuss AI policy, data centers, and the Ratepayer Protection Act. **Chairman Guthrie on _The Ra...
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CMS appeals Clover’s Medicare Advantage star ratings win
CMS is appealing its court loss that led to boosts in Clover Health’s 2026 Medicare Advantage star ratings. The case will now move to the U.S. Court of Appeals for the Eleventh Circuit, according to a July 21 court filing. Clover sued CMS in November, opposing measures it said contributed to its largest MA contract’s […] The post CMS appeals Clover’s Medicare Advantage star ratings win appeared first on Becker's Payer Issues | Payer News .
Clover Health -
Candid Health secures $120M series D as investment in AI-powered RCM ramps up
The company says its RCM platform, which leverages advanced automation to decrease the cost to collect and increase net collection rates, is now used by more than 200 healthcare organizations.
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CMS proposed rule lays groundwork for more OBBBA provider tax cutbacks
The agency took another step toward codifying and enacting provider tax thresholds outlined in last summer's One Big Beautiful Bill Act.
Policy / Regulatory Changes · 70 signals · last 30 days -
CMS appeals court decision behind 2026 MA star ratings recalculations
The Trump administration will appeal a Georgia court ruling that led it to broadly recalculate insurers' Medicare Advantage star ratings scores for 2026.
Policy / Regulatory Changes · 70 signals · last 30 days -
Community Health Systems misses on Q2 earnings, revenue
Similar to its for-profit peer HCA Healthcare, CHS said "an unfavorable change" in payer mix played a role in this quarter's numbers.
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Molina raises earnings guidance as profits drop 76% in Q2
Molina Healthcare reported $60 million in net income for the second quarter of 2026, a 76% year-over-year drop from $255 million. The insurer attributed the decline mainly to lower premium revenue and a higher medical loss ratio. Total revenue for the quarter was nearly $10.9 billion, down 4.8% year-over-year. Even with the profit decline, Molina […] The post Molina raises earnings guidance as profits drop 76% in Q2 appeared first on Becker's Payer Issues | Payer News .
MolinaMolina Healthcare · 1 signal · last 30 days -
No Surprises arbitration payouts hit $15B in 2025 alone: WSJ
The No Surprises Act’s arbitration process awarded close to $15 billion to out-of-network providers in 2025, more than three times the prior year’s total, according to a Wall Street Journal analysis of federal data. Payouts through the independent dispute resolution process reached $14.85 billion in 2025, up from $4.08 billion in 2024, the Journal reported. […] The post No Surprises arbitration payouts hit $15B in 2025 alone: WSJ appeared first on Becker's Payer Issues | Payer News .