Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
1195 signals
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House bill targets Medicare Advantage star ratings methodology
A newly introduced House bill is targeting the methodology behind Medicare Advantage star ratings, adding more pressure to a program that has seen years of litigation from insurers. The Medicare Advantage Strengthening Transparency and Accountability in Rating Systems Act, or MA STARS Act, was introduced Sept. 21 by Rep. Mike Kelly, R-Pa., and would direct […] The post House bill targets Medicare Advantage star ratings methodology appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 140 signals · last 30 days -
Healthfirst Health Plan Inc. v. Department of Health and Human Services et al.
Medicare Advantage Star Ratings litigation. The post Healthfirst Health Plan Inc. v. Department of Health and Human Services et al. appeared first on Health Care Litigation Tracker .
Policy / Regulatory Changes · 140 signals · last 30 days -
5 insurers launching new health plans
Medicare Advantage annual enrollment kicked off Oct. 15, and the ACA open enrollment period is around the corner. Employers are also navigating cost pressures, opening the door to innovative plans. Insurers have been primed to consider new health plans across commercial and government programs, and many are biting. Not every organization rolling out health plans […] The post 5 insurers launching new health plans appeared first on Becker's Payer Issues | Payer News .
Membership Movement · 18 signals · last 30 days -
Judi Health launching employer Medicare Part D plan with a focus on transparency
Judi Health is launching a new Part D plan that aims to lean on its tech stack to drive transparency and outcomes.
Policy / Regulatory Changes · 140 signals · last 30 days -
Judi Health launches Medicare Part D plan for employer groups
Health technology and benefits administration platform Judi Health is launching a Medicare Part D plan called Judi Rx Retire, according to an Oct. 20 news release. The product is a CMS-contracted and -approved Employer Group Waiver Plan, meaning employers can offer this prescription drug coverage to their Medicare-eligible retirees. Judi Rx Retire includes pharmacy networks, […] The post Judi Health launches Medicare Part D plan for employer groups appeared first on Becker's Payer Issues | Pa...
Policy / Regulatory Changes · 140 signals · last 30 days -
CMS releases 2 qualifying payment amount audits
The Centers for Medicare & Medicaid Services Oct. 20 published two qualifying payment amount audits under the No Surprises Act. The audits were of CareSource in Indiana and the School Employees Retirement System in Ohio, with both required to complete corrective actions following the audits. The CareSource audit focused on almost 25,000 claims, primarily concerning emergency and non-emergency services, while the School Employees Retirement System audit focused on six air ambulance claims. Bot...
CareSource · 2 signals · last 30 days -
Medicare broker eHealth could be delisted from Nasdaq
Health insurance brokerage company eHealth could be delisted from the Nasdaq stock exchange after the company’s shares closed below the $1 minimum bid price for 30 consecutive business days. In an Oct. 16 SEC filing, eHealth said it has until April 12, 2027, to regain compliance, which requires its shares to close at or above […] The post Medicare broker eHealth could be delisted from Nasdaq appeared first on Becker's Payer Issues | Payer News .
eHealtheHealth · 2 signals · last 30 days -
UnitedHealthcare names chief marketing officer
Karen Deutsch is stepping into UnitedHealthcare’s chief marketing officer role, according to an Oct. 19 LinkedIn post. Ms. Deutsch has spent four years with the insurer, serving as chief marketing officer of government programs and, before that, of Medicare and retirement, according to her LinkedIn profile. She previously served in marketing leadership roles at U.S. […] The post UnitedHealthcare names chief marketing officer appeared first on Becker's Payer Issues | Payer News .
UnitedHealthcareUnitedHealthcare · 46 signals · last 30 days -
CMS urges marketplace insurers to have brokers record consumer calls
Leading up to marketplace open enrollment, CMS issued guidance to insurers Oct. 19, encouraging greater oversight of agents and brokers. The memo focuses on issuers using the federally facilitated exchange. CMS expects issuers to follow much of the guidance beginning Nov. 1, when the enrollment period kicks off. CMS recommended that issuers have their agents […] The post CMS urges marketplace insurers to have brokers record consumer calls appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 140 signals · last 30 days -
Medicare Program; Implementation of Sections 6219, 6220, and 6224 of the Consolidated Appropriations Act, 2026
This proposed rule would implement section 6219 (Adjustments to Medicare Part D Cost-Sharing Reductions for Low-Income Individuals), section 6220 (Requiring Enhanced and Accurate Lists of (REAL) Health Providers Act), and section 6224 (Modernizing and Ensuring Pharmacy Benefit Manager Accountability) of the Consolidated Appropriations Act, 2026.
Policy / Regulatory Changes · 140 signals · last 30 days -
Trump Administration Announces More Than $16 Million for Rural Healthcare Workforce Training and Retention Across Maryland
Trump Administration Announces More Than $16 Million for Rural Healthcare Workforce Training and Retention Across Maryland This federal investment will prepare Marylanders for healthcare careers and help rural communities recruit and retain nurses, physicians, dentists, and other providers
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Centene to leave Hawaii Medicaid program in 2027
Centene’s ‘Ohana Health Plan is leaving Hawaii’s Medicaid managed care program, QUEST, on Dec. 31, according to a Sept. 1 letter to plan members. Centene also did not bid on the contract for Community Care Services, a behavioral health managed care program. Centene’s work under this contract ends Oct. 31, according to a statement shared […] The post Centene to leave Hawaii Medicaid program in 2027 appeared first on Becker's Payer Issues | Payer News .
Centene HawaiiCentene · 13 signals · last 30 days -
CMS lifts enrollment freeze on Massachusetts Medicare Advantage plans
CMS lifted an enrollment freeze for two contracts under eternalHealth, a Boston-based Medicare Advantage insurer, on Oct. 7. The agency imposed the freeze Aug. 27 after determining eternalHealth’s conduct “poses a serious threat to enrollee health and safety.” Earlier that month, the Massachusetts Division of Insurance placed eternalHealth under administrative supervision and required the insurer […] The post CMS lifts enrollment freeze on Massachusetts Medicare Advantage plans appeared first...
Policy / Regulatory Changes · 140 signals · last 30 days -
12% of calls to mental health clinicians in Blue Cross directories yield appointments: Study
Mental health ghost networks reach well beyond public insurance programs. Directory errors affected 55.6% of evaluable secret shopper calls to psychiatrists and psychologists listed by the largest commercial carrier in each of five states, according to a study published Oct. 16 in JAMA Health Forum. Researchers from the Ohio State University’s College of Public Health […] The post 12% of calls to mental health clinicians in Blue Cross directories yield appointments: Study appeared first on Be...
Blue Cross OhioBlue Cross Blue Shield plans · 36 signals · last 30 days -
CVS’ Oak Street Health gets chief medical officer
CVS Health named Maria Wilson, MD, as chief medical officer of Oak Street Health, the company’s value-based primary care centers for older adults. Dr. Wilson has been with Oak Street Health since 2017, most recently serving as an executive medical director, according to her LinkedIn profile. “It’s a privilege to take on this role in […] The post CVS’ Oak Street Health gets chief medical officer appeared first on Becker's Payer Issues | Payer News .
CVS HealthCVS Health / Aetna · 12 signals · last 30 days -
CMS issues proposals to improve MA plan provider directory accuracy, PBM transparency requirements and reduce drug costs
The Centers for Medicare & Medicaid Services released a proposed rule Oct. 16 seeking to codify regulations that will improve the accuracy of Medicare Advantage plan provider directories, establish transparency and compensation requirements for pharmacy benefit managers and their affiliates, and reduce copayments for generic drugs to $0 for low-income Medicare Part D beneficiaries. Among the proposed rule’s provisions, it would require MA plans to verify and update their provider directory in...
Policy / Regulatory Changes · 140 signals · last 30 days -
Maryland payer laying off 161 across 3 states
Provider Partners Health Plans is laying off 161 employees spanning three states, according to Oct. 7 Worker Adjustment and Retraining Notification, or WARN, notices. Provider Partners reported 79, 39 and 43 layoffs in Texas, Maryland and Illinois, respectively. The Texas and Maryland layoffs go into effect in early December. In late May, CMS said it […] The post Maryland payer laying off 161 across 3 states appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 140 signals · last 30 days -
UnitedHealth’s subsidiary count gets bigger
UnitedHealth Group’s count of subsidiaries and related entities has reached 2,807, according to the latest “Sunlight Report,” published in October. The report comes from the Center for Health & Democracy and is funded by Arnold Ventures. The updated report identified more entities since the findings published in July 2025, factoring in 2024 year-end and 2025 […] The post UnitedHealth’s subsidiary count gets bigger appeared first on Becker's Payer Issues | Payer News .
UnitedHealthUnitedHealthcare · 46 signals · last 30 days -
‘Don’t look at this as just a one-time product launch’: Cigna exec on Health Sense’s rollout
Cigna Healthcare in the first quarter of 2027 will roll out Health Sense, a tailored customer and clinical support model that brings together health, benefits and cost information. While the model will initially roll out for customers with oncology and cardiometabolic needs, Stanley Crittenden, MD, chief medical officer at Cigna Healthcare, told Becker’s that the […] The post ‘Don’t look at this as just a one-time product launch’: Cigna exec on Health Sense’s rollout appeared first on Becker'...
CignaCigna · 15 signals · last 30 days -
No one filed to run in a special Isle of Wight election. What happens now?
By Mechelle Hankerson / WHRO When Isle of Wight voters scan their ballot this election season, they’ll notice something different: Instead of names next to bubbles, voters will find a space to write in a name for recently vacated school board seat. Former school board member Brandi Perkins resigned from the board on July 31. […]
SCANSCAN Health Plan · 12 signals · last 30 days -
CMS proposes rule to clean up MA provider directories, shine light on PBMs
The proposed changes would implement key healthcare provisions in a government funding package from February. The brunt of the reforms would go into effect in 2028.
Policy / Regulatory Changes · 140 signals · last 30 days -
CMS proposes MA 'ghost network,' PBM transparency requirements
The administration took steps to codify statutory reforms focused on maintaining accurate Medicare Advantage provider directories and collecting more pricing information from pharmacy benefit managers.
Policy / Regulatory Changes · 140 signals · last 30 days -
General Motors to transition from BCBS Michigan to Aetna for salaried employees
One of Michigan’s largest employers, General Motors, is switching from Blue Cross Blue Shield of Michigan to Aetna for the administration of salaried, non-unionized employees’ health plans, as reported Oct. 8 by the Detroit Free Press and The Detroit News. An Aetna website confirmed the insurer will “become GM’s national medical carrier” starting in 2027. […] The post General Motors to transition from BCBS Michigan to Aetna for salaried employees appeared first on Becker's Payer Issues | Paye...
CVS Health / Aetna + Blue Cross Blue Shield plans · 46 signals · last 30 days -
CMS proposes public scores for Medicare Advantage provider directories, flat-fee limits for PBMs
CMS is pitching new guardrails for pharmacy benefit managers and Medicare Advantage plans under a proposed rule released Oct. 16. The proposed rule would implement sections of the Consolidated Appropriations Act of 2026. Comments are due Dec. 15. Here are eight things to know from the proposed rule: The post CMS proposes public scores for Medicare Advantage provider directories, flat-fee limits for PBMs appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 140 signals · last 30 days -
Trump Administration Announces $92 Million to Coordinate Rural Hospital Networks, Improve Maternal Care, and Expand Medical Services Across Ohio
Trump Administration Announces $92 Million to Coordinate Rural Hospital Networks, Improve Maternal Care, and Expand Medical Services Across Ohio This federal investment will connect rural providers and bring MRI, behavioral health, and maternal care closer to patients across Ohio
Competitive / Operational Strategy · 36 signals · last 30 days