Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
722 signals
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Louisiana’s Medicaid program will lose another provider, affecting 290,000 people
The Healthy Blue plan, offered by Elevance Health and Blue Cross Blue Shield of Louisiana, will no longer be available to Medicaid recipients in 2027.
Elevance Health + Blue Cross Blue Shield plans · 29 signals · last 30 days -
CHI St. Vincent no longer part of Blue Cross Blue Shield of Arkansas network
CHI St. Vincent will not be part of the Blue Cross Blue Shield of Arkansas network after the Little Rock-based hospital system and the insurer failed to reach an agreement on renewing their contract, both sides announced Tuesday. The two failed to reach an agreement during negotiations over the past several months about how much […]
Blue Cross Blue Shield plans · 20 signals · last 30 days -
Ohio Chamber sues UnitedHealthcare over alleged effort to poach members
The Ohio Chamber of Commerce is suing UnitedHealthcare over allegations the insurer withheld data and used confidential information obtained as the administrator of the chamber’s health benefits program to steer small businesses into its own plans. Hours after the lawsuit was filed Sept. 1 in an Ohio federal court, U.S. District Judge Algenon Marbley temporarily […] The post Ohio Chamber sues UnitedHealthcare over alleged effort to poach members appeared first on Becker's Payer Issues | Payer...
UnitedHealthcare OhioUnitedHealthcare · 34 signals · last 30 days -
Hospital groups rail against CMS' proposed 340B changes, site-neutral payments
Public comments for the latest OPPS proposed rule saw several major hospital groups all but threatening a court showdown over CMS' planned policy changes.
Policy / Regulatory Changes · 67 signals · last 30 days -
6 payer reimbursement changes to know in September
Several of the nation’s largest health insurers rolled out reimbursement policy changes Sept. 1, ranging from new lab testing coverage limits at UnitedHealthcare to a billing overhaul at Blue Cross Blue Shield of Michigan that has drawn pushback from providers. Six payer reimbursement changes to know: 1. UnitedHealthcare UnitedHealthcare is tightening reimbursement for lab tests […] The post 6 payer reimbursement changes to know in September appeared first on Becker's Payer Issues | Payer News .
UnitedHealthcare + Blue Cross Blue Shield plans · 53 signals · last 30 days -
Johns Hopkins Health Plans names interim CEO
Daniel Chojnowski will serve as the interim CEO for Johns Hopkins Health Plans. According to a Sept. 1 LinkedIn post from the insurer, Mr. Chojnowski has served as CFO for the past seven years. He previously held financial leadership roles at Portland, Maine-based Martin’s Point Health Care, his LinkedIn profile said. In August, Humana tapped […] The post Johns Hopkins Health Plans names interim CEO appeared first on Becker's Payer Issues | Payer News .
Humana MaineHumana · 13 signals · last 30 days -
UnitedHealthcare to participate in Mississippi’s short-term plans push
Mississippi Insurance Commissioner Mike Chaney confirmed UnitedHealthcare will offer short-term, limited-duration insurance through the Mississippi Comprehensive Health Insurance Risk Pool Association, with a projected start date in 2027. The short-term plans will run for a maximum of 364 days, Mr. Chaney told Becker’s. These plans are not ACA compliant, meaning they do not offer the […] The post UnitedHealthcare to participate in Mississippi’s short-term plans push appeared first on Becker's...
UnitedHealthcare MississippiUnitedHealthcare · 34 signals · last 30 days -
Head of UnitedHealthcare’s Illinois market to oversee Wisconsin, Michigan
The head of UnitedHealthcare’s Illinois plan will now oversee Wisconsin and Michigan.
UnitedHealthcare · 34 signals · last 30 days -
Trump Administration Announces $58 million to Deliver New Ambulances and Upgrade Emergency Communications Systems Across Hawaii
Trump Administration Announces $58 million to Deliver New Ambulances and Upgrade Emergency Communications Systems Across Hawaii This federal investment will help expand access, strengthen the health workforce, improve infrastructure, and advance technology for rural communities across Hawaii
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UnitedHealthcare to drop prior authorization requirements for 1,700 services
UnitedHealthcare has released the specific procedure codes it will exempt from prior authorization as part of the insurer’s previous pledge to reduce requirements by 30% before the end of 2026. The code lists cover 1,700 procedure codes for a range of services across commercial, Medicare Advantage, individual exchange, and Medicaid plans. Effective Oct. 1, providers […] The post UnitedHealthcare to drop prior authorization requirements for 1,700 services appeared first on Becker's Payer Issue...
UnitedHealthcareUnitedHealthcare · 34 signals · last 30 days -
Medicare Advantage disenrollment jumps with each complex diagnosis: Study
Each complex condition further drives Medicare Advantage disenrollment, according to research published Aug. 21 in JAMA Health Forum. Researchers from Baltimore-based Johns Hopkins University reviewed a cohort of more than 1 million MA beneficiaries to determine transitions to traditional Medicare or other MA plans. Here are six notes from the research: The post Medicare Advantage disenrollment jumps with each complex diagnosis: Study appeared first on Becker's Payer Issues | Payer News .
Membership Movement · 5 signals · last 30 days -
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 · 67 signals · last 30 days -
United States v. Anthem, Inc.
Case 1:20-cv-02593-ALC-KHP Document571_ Filed 09/01/26 Page1of9 U.S. Department of Justice United States Attorney Southern District of New York 86 Chambers Street New York, New York 10007 September 1, 2026 Via ECF The Honorable Katharine H. Parker United States District Court 500 Pearl Street New York, New York 10007 Re: = United States of America v. Anthem, Inc., No. 20 Civ. 2593 (ALC) (KHP) Dear Judge Parker: This Office represents the Government in the above-referenced matter. We write Ori...
Anthem New YorkElevance Health · 11 signals · last 30 days -
PUBLIC COMMENT — Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems, etc, CMS-1850-P, RIN 0938-AV83
The post PUBLIC COMMENT — Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems, etc, CMS-1850-P, RIN 0938-AV83 appeared first on Paragon Health Institute .
Policy / Regulatory Changes · 67 signals · last 30 days -
In next phase of sustainability, UCI Health, Kaiser Permanente, and others turn to electric hospitals
The U.S. healthcare sector is responsible for about 9% of the country’s greenhouse gas emissions. A growing number of providers have implemented sustainability agendas, with electrification being the next frontier.
KaiserKaiser Permanente · 5 signals · last 30 days -
STAT+: GLP-1 drugs are almost single-handedly forcing employers to reconsider workers’ health care
Another hospital system sues CVS Health, how Medicaid cuts will change everything, and more
CVS HealthCVS Health / Aetna · 10 signals · last 30 days -
DOJ steps up crackdown on Medicare Advantage upcoding
The Justice Department’s scrutiny of Medicare Advantage risk adjustment is intensifying, with two recent settlements totaling nearly $1.1 billion highlighting federal concerns about diagnosis coding practices that can increase payments to health plans. The latest came Aug. 27, when The Villages (Fla.) Health System agreed to pay $541.5 million to resolve allegations that it violated […] The post DOJ steps up crackdown on Medicare Advantage upcoding appeared first on Becker's Payer Issues | Pa...
Policy / Regulatory Changes · 67 signals · last 30 days -
UnitedHealthcare taps CEO for Washington state Medicaid plan
UnitedHealthcare Community Plan of Washington has named Scott Williams as CEO. According to an August LinkedIn post, Mr. Williams will work with members, providers, community groups, tribes and state leaders in his role with the Medicaid managed care plan. Prior to this position, Mr. Williams was a vice president of network contracting with UnitedHealth Group. […] The post UnitedHealthcare taps CEO for Washington state Medicaid plan appeared first on Becker's Payer Issues | Payer News .
UnitedHealthcare · 34 signals · last 30 days -
Centene names new CIO
Centene has named Bradley Bolivar as its new chief information officer, effective Aug. 31. Mr. Bolivar previously served as CIO at Fannie Mae, where he led enterprise technology strategy across application development, infrastructure, cybersecurity, data, artificial intelligence and workplace technology. He has also held leadership roles at Warner Bros. Entertainment. He succeeds Brian LeClaire, who […] The post Centene names new CIO appeared first on Becker's Payer Issues | Payer News .
CenteneCentene · 11 signals · last 30 days -
Centene taps Fannie Mae executive as CIO
Bradley Bolivar is taking the reins of Centene’s IT strategy as artificial intelligence drives a sea change for how insurers do business.
CenteneCentene · 11 signals · last 30 days -
Maryland sues Optum over 'defective' computer system
Maryland has filed a lawsuit against UnitedHealth Group, alleging that its Optum unit defrauded the state's Medicaid program by providing a faulty computer system.
UnitedHealthcare · 34 signals · last 30 days -
Trump admin blocks over $1.6B in potentially fraudulent Medicare lab payments: CMS
The CMS Fraud Defense Operations Center has also accounted for more than $371 million in Medicare suspended payments involving 267 providers and suppliers since Jan. 1, the agency said.
Policy / Regulatory Changes · 67 signals · last 30 days -
CMS Prevents $1.6 Billion in Fraudulent Medicare Laboratory Payments
CMS Prevents $1.6 Billion in Fraudulent Medicare Laboratory Payments 157 fraudulent lab providers revoked from Medicare program Centers for Medicare & Medicaid Services (CMS) enforcement actions have stopped more than $1.6 billion in potentially improper Medicare laboratory payments since the start of the Trump Administration – further evidence that CMS’ efforts to crush fraud are working to protect taxpayer dollars and improve Medicare program integrity. This includes $732 million in savings...
Policy / Regulatory Changes · 67 signals · last 30 days -
CMS touts blocking $1.6B in potentially fraudulent Medicare payments
CMS said its enforcement efforts have resulted in blocking more than $1.6 billion in possibly improper Medicare lab payments throughout President Trump’s administration. An Aug. 28 CMS news release said these enforcement actions included savings of $732 million from 157 providers with revoked Medicare privileges, and a CMS investigation of 600 labs that resulted in 185 payment […] The post CMS touts blocking $1.6B in potentially fraudulent Medicare payments appeared first on Becker's Payer Is...
Policy / Regulatory Changes · 67 signals · last 30 days -
Massachusetts Medicare Advantage insurer hit with enrollment freeze again
CMS has again suspended enrollment for two Medicare Advantage prescription drug plans offered by Boston-based EternalHealth, the second time in less than two years that the insurer has faced sanctions. The agency said Aug. 27 the enrollment freeze on the two plans is based on its determination that EternalHealth’s conduct “poses a serious threat to […] The post Massachusetts Medicare Advantage insurer hit with enrollment freeze again appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 67 signals · last 30 days