Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
729 signals
-
Village of Glenwood, Blue Cross and Blue Shield of Illinois, and National Fitness Campaign Provide Free Fitness for Everyone in Glenwood
The Village of Glenwood, Blue Cross and Blue Shield of Illinois, and National Fitness Campaignexternal link, today announced a partnership to bring an outdoor Fitness Court and digital wellness programming to The Village of Glenwood. The Fitness Court, located at Arquilla Park, 225 Park Drive, Glenwood, will open July 25th at 10:00 a.m. with a ribbon-cutting ceremony.
Blue Cross Blue Shield plans · 21 signals · last 30 days -
UnitedHealth Group in the headlines: 10 updates
From posting nearly $5.5 billion in profit for the second quarter, to its Optum arm striking a partnership with Anthropic, here are 10 updates on UnitedHealth Group and its subsidiaries that Becker’s has reported since July 2: 1. UnitedHealth Group still expects a Medicare Advantage enrollment loss for 2026, but the company lowered its projection […] The post UnitedHealth Group in the headlines: 10 updates appeared first on Becker's Payer Issues | Payer News .
UnitedHealthOptumUnitedHealthcare · 37 signals · last 30 days -
Clover Health reveals data breach in SEC filing
Clover Health has disclosed a data breach in a new securities filing, though details on the incident are scarce.
Clover Health -
Guidance issued on new claims processing codes following independent dispute resolution updates
The Centers for Medicare & Medicaid Services released guidance July 17 on new remittance advice remark codes required for use following updates to the No Surprises Act independent dispute resolution process. RARCs are standardized codes that convey information about claims processing. The guidance specifies circumstances in which group health plans and health insurance issuers offering group or individual health insurance coverage must use each RARC and technical instructions to facilitate us...
Financial / Operating Pressure · 13 signals · last 30 days -
District court pauses 8 provisions from 2027 notice of benefit and payment parameters final rule
The U.S. District Court for the District of Maryland July 16 enjoined eight provisions from the Centers for Medicare & Medicaid Services’ 2027 notice of benefit and payment parameters final rule, which were set to become effective July 20. The final rule issues standards for qualified health plans offered through the health insurance marketplaces. The injunction pauses multiple policies that the AHA previously raised concerns about, including an expansion of annual out-of-pocket maximums for...
Policy / Regulatory Changes · 70 signals · last 30 days -
S. 3303, Leveraging Integrated Networks in Communities for Veterans Act
As ordered reported by the Senate Committee on Veterans’ Affairs on March 18, 2026
-
Maryland failed to audit $675M in Medicaid pharmacy claims: 5 notes
The Maryland Department of Health did not audit pharmacy claims for three of its four fee-for-service pharmacy programs, leaving approximately $674.5 million in fiscal 2025 claims without routine reviews for fraud, waste, abuse and billing violations, according to a July 13 audit from the Maryland Office of Legislative Audits. The agency agreed with the audit’s […] The post Maryland failed to audit $675M in Medicaid pharmacy claims: 5 notes appeared first on Becker's Payer Issues | Payer News .
-
Judge pauses ACA catastrophic plan expansion, 7 other provisions
A federal judge has paused eight provisions of CMS’ 2027 ACA marketplace rule, blocking a slate of eligibility, verification and plan design changes just days before they were set to take effect July 20. Judge Brendan Hurson of the U.S. District Court for the District of Maryland granted the stay July 16 in City of […] The post Judge pauses ACA catastrophic plan expansion, 7 other provisions appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 70 signals · last 30 days -
Proposed bill would create Medicare exchange plan, make enhanced ACA subsidies permanent
A newly proposed federal bill would create a government-run public health insurance option sold on the ACA exchanges and permanently extend the enhanced premium subsidies that lapsed at the end of 2025. The Medicare-X Choice Act, introduced July 15 by Rep. Angie Craig, D-Minn., would establish a “Medicare Exchange health plan,” on the individual and […] The post Proposed bill would create Medicare exchange plan, make enhanced ACA subsidies permanent appeared first on Becker's Payer Issues | P...
Financial / Operating Pressure · 13 signals · last 30 days -
Entries open for Modern Healthcare’s Best in Business Awards
Behind every great healthcare outcome is a network of partners working hard to make it possible. From technology and staffing to legal, logistics and consulting, Best in Business recognizes those powering progress.
-
STAT+: The next step of site-neutral, and a fiery PBM hearing
Medicare proposes to reduce payments to hospitals for certain drugs and imaging services.
Competitive / Operational Strategy · 39 signals · last 30 days -
UnitedHealthcare reduces MA enrollment loss projection for 2026
UnitedHealth Group still expects a Medicare Advantage enrollment loss for 2026, but the company lowered its projection on a July 16 earnings call. During the company’s fourth-quarter and full-year 2025 results in January, UnitedHealthcare CEO Tim Noel said he expected a loss between 1.3 million and 1.4 million MA members in 2026. In April, the […] The post UnitedHealthcare reduces MA enrollment loss projection for 2026 appeared first on Becker's Payer Issues | Payer News .
UnitedHealthcareUnitedHealthUnitedHealthcare · 37 signals · last 30 days -
STAT+: Pharmalittle: We’re reading about a telehealth firm and patient safety, PBMs overcharging, and more
Some former employees say telehealth company LifeMD has sought to maximize the volume of GLP-1 prescriptions at the expense of patient safety
-
Why CMS’ Shared Savings proposals matter for ACO growth
The Centers for Medicare and Medicaid Services is eager to attract more physicians to value-based care initiatives such as the Medicare Shared Savings Program.
Policy / Regulatory Changes · 70 signals · last 30 days -
Clover Health hit with data breach
The insurer, which disclosed the breach in a securities filing late last week, doesn’t yet know what type of data was exposed or how many people may have been impacted.
Clover Health -
What will it take to achieve real-time claims adjudication?
The future of healthcare finance requires a platform that can power trust between providers and payers
-
STAT+: Telemedicine company touted by Novo Nordisk stressed profits over patient safety, ex-workers say
LifeMD, a popular telehealth company, has been accused by former employees of pressing clinicians to mete out prescriptions more rapidly without sufficient screening and follow-up.
-
STAT+: State audit of Medicaid records points to methods used by PBMs to obscure drug costs
An audit of state Medicaid records revealed how PBMs are using complicated tactics for handling prescription drug claims that ultimately overcharge taxpayers.
-
GAOverview: Recent Federal Workforce Changes at OPM
Why This Matters The Office of Personnel Management (OPM) is the federal government's central agency for human resources and workforce management. Since December 2024, in alignment with presidential directives on the closure of certain offices and the reduction of the size of the federal workforce, OPM has undergone significant workforce and organizational structure changes. These actions have reduced institutional knowledge and operational capacity at the agency. OPM’s Headcount Decreased by...
-
How Medicare Advantage plans can strengthen Star Ratings through better care transitions
Why leading Medicare Advantage plans are making care transitions a strategic priority.
Policy / Regulatory Changes · 70 signals · last 30 days -
3 essential capabilities to scale impact and collaboration in VBC
Discover the critical tools you need to succeed in a collaborative, tech-enabled VBC future.
-
The real economics of specialty pharmacy: What your specialty drug trend isn’t telling you
As specialty drug costs rise, payers with a comprehensive view can better manage them.
-
Medicare Program; Inflation Reduction Act of 2022 (IRA) Medicare Drug Price Negotiation Program Draft Guidance; Comment Request
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' draft guidance for the Medicare Drug Price Negotiation Program regarding manufacturer effectuation of the maximum fair price in 2028 for the implementation of the Inflation Reduction Act of 2022 (IRA) (Pub. L. 117-169). CMS' draft guidance and other IRA-related guidance can be viewed on the CMS website at https://www.cms.gov/priorities/medicare- prescription-drug-affordability/med...
Policy / Regulatory Changes · 70 signals · last 30 days -
Value-Based DME Model Aims to Improve Outcomes for Patients, Payers and Providers
Learn how value-based durable medical equipment (DME) strategies can improve patient outcomes, reduce costs, strengthen provider networks and support coordinated post-acute care.
-
CMS proposes major Medicare reforms to shift physician pay, phase out MIPS and expand ACO participation
The Trump administration is proposing sweeping changes to Medicare payment and value-based care programs it says will expand accountable care, modernize physician payment and help shift the healthcare system toward prevention instead of treatment.
Policy / Regulatory Changes · 70 signals · last 30 days