Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
722 signals
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Listening to the Frontlines: Kaiser Permanente’s Lessons on Integrating Doulas for Medi-Cal
Kaiser Permanente's experience with California's doula benefit reveals the importance of listening to the people closest to the work. The post Listening to the Frontlines: Kaiser Permanente’s Lessons on Integrating Doulas for Medi-Cal appeared first on California Health Care Foundation .
Kaiser CaliforniaKaiser Permanente · 5 signals · last 30 days -
BCBS Tennessee pivots away from AI program that monitored employee work
BlueCross BlueShield of Tennessee has moved away from AI software that monitored employee work, according to an Aug. 19 report from the Chattanooga Times Free Press. The insurer confirmed to Becker’s that it recently ended a pilot based on employee feedback. The company had been using Skan AI, a platform that observes workflows and business […] The post BCBS Tennessee pivots away from AI program that monitored employee work appeared first on Becker's Payer Issues | Payer News .
BCBS TennesseeBlue Cross Blue Shield plans · 20 signals · last 30 days -
Only 13% of Medicare beneficiaries can accurately define coverage options: Survey
There’s widespread gaps in Medicare knowledge among both current beneficiaries and adults approaching eligibility for the program, even as most enrollees express high confidence in their understanding of the program, according to a new eHealth survey. The findings, released Aug. 20, were based on nationwide surveys of 1,000 adults conducted by a third-party vendor from […] The post Only 13% of Medicare beneficiaries can accurately define coverage options: Survey appeared first on Becker's Pay...
eHealtheHealth · 1 signal · last 30 days -
Humana names chief medical officer
Humana tapped Shantanu Nundy, MD, to serve as the company’s chief medical officer, effective Aug. 31. According to an Aug. 20 news release, Dr. Nundy will inform the company’s AI use, products and platforms. He will report to Humana President and CEO Jim Rechtin, serving on the company’s enterprise leadership team. “I am confident Shantanu’s […] The post Humana names chief medical officer appeared first on Becker's Payer Issues | Payer News .
HumanaHumana · 13 signals · last 30 days -
Centene to cut some Medicare Advantage plans, exit 3 states
Centene's strategy could cost it about one-third of its Medicare Advantage membership.
CenteneCentene · 11 signals · last 30 days -
Oklahoma’s new cancer screening requirement isn’t as transparent for patients as it should be
For a patient with a high risk of a cancer diagnosis, the most frightening part of an extra scan should be the result, not the bill that may arrive weeks later. Oklahoma’s new cancer coverage laws, Senate Bill 109 and House Bill 1389, became law last year. They were written around a simple idea: no […]
SCAN OklahomaSCAN Health Plan · 11 signals · last 30 days -
Humana taps physician executive as new chief medical officer
Dr. Shantanu Nundy is joining the Kentucky-based insurer from health navigation firm Accolade. But he’s had a varied career — advising the FDA on AI, teaching, working for the World Bank, practicing medicine and more.
Humana KentuckyHumana · 13 signals · last 30 days -
Privacy Act of 1974; System of Records
In accordance with the Privacy Act of 1974, as amended, the Department of Health and Human Services (HHS) is establishing a new system of records to be maintained by the Centers for Medicare & Medicaid Services (CMS), titled "Nurses for Nursing Homes Program (NNHP)," system No. 09-70-0545. The new system of records will cover the collection of records on individuals who apply for, participate in, or otherwise support the Nurses for Nursing Homes Program (NNHP). Records maintained in the syste...
Policy / Regulatory Changes · 67 signals · last 30 days -
Mount Sinai quietly stops accepting some new patients with government-backed plans
New York City-based Mount Sinai Health System is no longer accepting some new patients with government-backed health coverage, according to since-removed notices on its website. An archived webpage shows how Mount Sinai stopped accepting new patients with Centene’s Fidelis Care Medicaid, exchange and Medicare Advantage coverage, as well as Wellcare Medicare Advantage coverage, as of Aug. 1. […] The post Mount Sinai quietly stops accepting some new patients with government-backed plans appeare...
Centene · 11 signals · last 30 days -
Trump Administration Announces $35 million Investment to Advance Screening Technology, Secure Additional Operating Rooms, and Modernize Rural Pennsylvania Healthcare
Trump Administration Announces $35 million Investment to Advance Screening Technology, Secure Additional Operating Rooms, and Modernize Rural Pennsylvania Healthcare This federal investment will help provide technology, equipment and expanded transportation options for communities across Pennsylvania
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CMS News: Trump Administration Announces $35 million to Support Investments in Rapid Response Capabilities to Improve Rural Pennsylvania Healthcare
Trump Administration Announces $35 million to Support Investments in Rapid Response Capabilities to Improve Rural Pennsylvania Healthcare Federal investment will help provide technology, equipment and expanded transportation options for communities across Pennsylvania The Trump Administration announced that $35 million, made possible through the federal Rural Health Transformation Program (RHTP), is being put to work to improve health outcomes among rural Pennsylvanians by updating to new, mo...
Policy / Regulatory Changes · 67 signals · last 30 days -
‘No-brainer’: PBMs commit to posting TrumpRx price comparisons
The Pharmaceutical Care Management Association and its members committed to sharing TrumpRx’s cash prices for drugs through their real-time benefit tools and other cost transparency platforms. An Aug. 13 news release said the association coordinated with the Trump administration and CMS Administrator Mehmet Oz, MD, on the effort. PCMA members include Elevance Health’s CarelonRx, CVS […] The post ‘No-brainer’: PBMs commit to posting TrumpRx price comparisons appeared first on Becker's Payer Is...
ElevanceElevance Health · 11 signals · last 30 days -
Alignment looks to dismiss whistleblower complaint from former executive
Alignment Healthcare is asking a federal court to throw out a whistleblower lawsuit brought by a former executive who alleged retaliation from company leadership after reporting concerns over its accounting practices. The Medicare Advantage insurer filed its motion to dismiss Aug. 18 in the U.S. District Court for the Central District of California, targeting claims […] The post Alignment looks to dismiss whistleblower complaint from former executive appeared first on Becker's Payer Issues |...
Alignment Healthcare CaliforniaAlignment Healthcare · 2 signals · last 30 days -
Centene’s Health Net taps CEO from Nevada health plan
Centene’s Health Net named Eric Schmacker as plan president and CEO. Mr. Schmacker most recently held the same role at Silver Summit Health Plan, another Centene plan in Nevada, a LinkedIn announcement said. Leading up to his official appointment, he has been Health Net’s interim plan president and CEO. Before Centene, Mr. Schmacker held executive […] The post Centene’s Health Net taps CEO from Nevada health plan appeared first on Becker's Payer Issues | Payer News .
Centene NevadaCentene · 11 signals · last 30 days -
Trump Administration Announces $90 million to Modernize and Improve IT and Interoperability for South Dakota
Trump Administration Announces $90 million to Modernize and Improve IT and Interoperability for South Dakota Federal investment will help fast-track IT modernization, boost cybersecurity, and improve interoperability in rural and underserved communities across South Dakota
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Providence Health Plan to close completely after Medicare Advantage deal falls through
The regional health plan was in talks with an unnamed national insurer to keep its MA plans afloat. But the agreement sputtered “despite significant effort on all sides,” a Providence spokesperson said.
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AMA applauds updated CMS prior authorization reporting guidance
The organization said the agency responded to its concerns about payers' implementation of the transparency provisions of the 2024 final rule.
Policy / Regulatory Changes · 67 signals · last 30 days -
Centene’s Health Net to end assisted living transition service for Medi-Cal members
Centene’s Health Net is rolling back an assisted living transition service for Medi-Cal members, a health plan spokesperson confirmed to Becker’s on Aug. 18. Through the California Advancing and Innovating Medi-Cal initiative — a multiyear transformation plan for the state’s Medicaid program — Community Supports are optional services to address health-related social needs. For example, […] The post Centene’s Health Net to end assisted living transition service for Medi-Cal members appeared fi...
Centene CaliforniaCentene · 11 signals · last 30 days -
CommonSpirit’s 5 targets for judging payer prior auth reform — and its Humana milestone
In 2025, insurers committed to scaling back and simplifying prior authorization as they fall into line with standards established by the 2024 Interoperability and Prior Authorization and Medicare Advantage final rules. But recent aggregated data on prior authorization — which insurers now have to report, thanks to the 2024 regulation — lacks relevant context. For […] The post CommonSpirit’s 5 targets for judging payer prior auth reform — and its Humana milestone appeared first on Becker's Pay...
HumanaHumana · 13 signals · last 30 days -
UnitedHealth Group in the headlines: 10 updates
From posting a $5.5 billion profit in the second quarter, to a former UnitedHealthcare executive being confirmed as the next CDC director, here are 10 updates on UnitedHealth Group and its subsidiaries that Becker’s has reported since July 20: 1. Luigi Mangione pleaded guilty to federal stalking charges in connection with the December 2024 killing […] The post UnitedHealth Group in the headlines: 10 updates appeared first on Becker's Payer Issues | Payer News .
UnitedHealthcareUnitedHealthUnitedHealthcare · 34 signals · last 30 days -
Scan Health Plan, Costco team up on Medicare plans
A deal with Costco gives Scan Health Plan access to a massive customer base.
SCANSCAN Health Plan · 11 signals · last 30 days -
Alignment Health seeks to have former exec's whistleblower suit tossed
Alignment Healthcare and several of its executives have filed a motion to have a whistleblower suit filed by a former exec dismissed.
Alignment HealthcareAlignment Healthcare · 2 signals · last 30 days -
Alignment files motion to dismiss whistleblower lawsuit
The lawsuit accuses the Medicare Advantage insurer of allegedly manipulating its finances to boost its stock price.
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Evernorth payer solutions president tapped to lead Cambia TPA
Healthcare Management Administrators, a third-party administrator owned by Cambia Health Solutions, has named Diane Zalewski as CEO. Ms. Zalewski most recently served as president of payer solutions at Cigna’s Evernorth. Before Evernorth, she held several roles at Cigna, including COO of payer solutions. HMA designs and administers health plans for self-funded employers and has been […] The post Evernorth payer solutions president tapped to lead Cambia TPA appeared first on Becker's Payer Iss...
CignaCigna · 10 signals · last 30 days -
UnitedHealthcare expands behavioral coaching to 13 million members
UnitedHealthcare expanded its child and family behavioral coaching program, giving approximately 13 million eligible commercial members access to behavioral health support. The 2026 expansion adds access for an additional 5 million members at no added cost for employers with fully insured plans. More than 500 employers now offer the program, according to an Aug. 18 news release […] The post UnitedHealthcare expands behavioral coaching to 13 million members appeared first on Becker's Payer Iss...
UnitedHealthcareUnitedHealthcare · 34 signals · last 30 days