Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
1203 signals
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Strengthening Medicare Advantage in 2028: ACHP Recommendations to CMS
ACHP urges CMS to simplify risk adjustment, modernize network adequacy and refine Star Ratings in 2028 to protect Medicare Advantage beneficiary choice. Source
Policy / Regulatory Changes · 140 signals · last 30 days -
UnitedHealthcare mistakenly tells members that 8 clinicians died
UnitedHealthcare recently sent letters to members across the country mistakenly informing them that eight physicians had died, as first reported by The Minnesota Star Tribune on Oct. 7. According to the report, letters claiming the deaths of two Minnesota physicians were dated Sept. 11. Two weeks later, members received letters addressing the mistake and confirming […] The post UnitedHealthcare mistakenly tells members that 8 clinicians died appeared first on Becker's Payer Issues | Payer News .
UnitedHealthcare MinnesotaUnitedHealthcare · 47 signals · last 30 days -
PhRMA launches new legal challenge as CMS brings 'most favored nation' pricing to Medicare Part B
As the Trump administration advances plans to bring its “most favored nation” drug pricing model to Medicare Part B, the pharmaceutical industry’s top lobbying group is pushing back in court.
Policy / Regulatory Changes · 140 signals · last 30 days -
Medicare penalizes more hospitals for readmissions
About 80% of hospitals are having their Medicare payments shaved down over high readmission rates this fiscal year, compared with 78% the year prior, according to new CMS data. It continues a worrying trend.
Policy / Regulatory Changes · 140 signals · last 30 days -
Opinion: How CMS plans to fix a major flaw in the 340B drug discount program
“A small, well-intended discount for safety net hospitals became a large institutional subsidy with expensive unintended consequences,” writes an HHS leader.
Policy / Regulatory Changes · 140 signals · last 30 days -
Clinical Laboratory Improvement Amendments of 1988 (CLIA); Virtual Access, Gynecologic Cytology Proficiency Testing (PT), Personnel Qualifications, and Other Changes
This proposed rule would amend the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations to allow for virtual access under the CLIA certificate of the primary testing laboratory that generated the data, with the exception of the subspecialty of cytology, and the use of digital images for gynecologic cytology proficiency testing. This proposed rule also includes proposed changes to personnel qualification requirements and other proposed changes pertaining to SARS-CoV-2 reportin...
Policy / Regulatory Changes · 140 signals · last 30 days -
Cigna unveils new customer experience platform, Health Sense
Cigna is rolling out a new patient experience platform that aims to harness the power of data to drive greater personalization.
CignaCigna · 15 signals · last 30 days -
Kaiser Permanente to repay nurses 'potentially tens of millions' in mistakenly withheld wages
Following an arbitration agreement, more than 1,000 nurses will be compensated for a payment error that began in 2021, the California Nurses Association said. The major nonprofit confirmed the plans but did not comment on the total amount.
Kaiser CaliforniaKaiser Permanente · 4 signals · last 30 days -
HCA hospitals escalate payment fight with insurers
Hospitals affiliated with Nashville, Tenn.-based HCA Healthcare have sued multiple insurers over alleged claim denials and reimbursement issues in 2025 and 2026. These cases contribute to a broader landscape of legal battles between providers and insurers. Most recently, seven hospitals filed a lawsuit Oct. 5 against Anthem Blue Cross and Blue Shield Georgia, part of […] The post HCA hospitals escalate payment fight with insurers appeared first on Becker's Payer Issues | Payer News .
Elevance Health + Blue Cross Blue Shield plans · 48 signals · last 30 days -
7 HCA-affiliated hospitals sue Anthem BCBS over reimbursement
Seven hospitals affiliated with Nashville, Tenn.-based HCA Healthcare filed a lawsuit Oct. 5 against Anthem Blue Cross and Blue Shield in Georgia, part of Elevance Health, alleging denied or underpaid claims, according to court records reviewed by Becker’s. Corpus Christi Medical Center, HCA Houston Healthcare North Cypress, Lone Peak Hospital, TriStar Skyline Medical Center, Belton […] The post 7 HCA-affiliated hospitals sue Anthem BCBS over reimbursement appeared first on Becker's Payer Iss...
Elevance Health · 16 signals · last 30 days -
Health plan enrollment drops 2.8% as individual market, Medicaid shrink
Health insurers’ membership declined 2.8% year-over-year to about 312.5 million people in the first half of 2026, as losses in the individual market and Medicaid outpaced gains in Medicare Advantage and employer-based plans. The figures come from a Sept. 29 analysis by Mark Farrah Associates, which draws on statutory financial filings with the National Association […] The post Health plan enrollment drops 2.8% as individual market, Medicaid shrink appeared first on Becker's Payer Issues | Pay...
Membership Movement · 18 signals · last 30 days -
Keeping claims out of IDR: How payers are containing No Surprises Act costs
The No Surprises Act has delivered on one of its central promises: fewer surprise medical bills. A survey from AHIP and the Blue Cross Blue Shield Association found that the NSA protected patients from nearly 20 million potential surprise bills in 2024 alone. But the law has not worked as intended in every respect. For […] The post Keeping claims out of IDR: How payers are containing No Surprises Act costs appeared first on Becker's Payer Issues | Payer News .
Blue CrossBlue ShieldBlue Cross Blue Shield plans · 36 signals · last 30 days -
SCAN, Walmart are teaming up for co-branded MA plans. Here's why
Last month, SCAN Health Plan revealed that it would team up with Walmart to launch co-branded Medicare Advantage plans in two states. Now, the partners are offering a deeper look at how those benefits have taken shape, and why they saw potential in coming together.
SCANSCAN Health Plan · 13 signals · last 30 days -
Trump Administration Announces More Than $17 Million for New Mental Health Clinics, Mobile Crisis Teams, and Expanded Addiction Treatment in North Carolina
Trump Administration Announces More Than $17 Million for New Mental Health Clinics, Mobile Crisis Teams, and Expanded Addiction Treatment in North Carolina This federal investment will bring crisis support directly to children and families and improve access to addiction and maternal mental health care across rural North Carolina
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GLP-1 spending rose 84% in 1 year at BCBS Massachusetts: Study
Higher use of medical services and prescription drugs, rather than rising inflation-adjusted prices, drove a recent uptick in commercial spending at Blue Cross Blue Shield of Massachusetts, according to a study published Oct. 5 in Health Affairs. The analysis was conducted by researchers from Harvard University, along with senior leadership from BCBSMA, including its chief […] The post GLP-1 spending rose 84% in 1 year at BCBS Massachusetts: Study appeared first on Becker's Payer Issues | Pay...
Blue Cross Blue Shield plans · 36 signals · last 30 days -
Humana taps CEO for Kentucky Medicaid
Mitchell Evans will serve as Humana’s next Kentucky Medicaid CEO, according to an Oct. 6 LinkedIn post. According to Mr. Evans’ LinkedIn profile, he has spent more than 15 years with Humana, most recently as a national vice president for Medicaid growth and strategy. Mr. Evans has also served on the Medicaid Health Plans of […] The post Humana taps CEO for Kentucky Medicaid appeared first on Becker's Payer Issues | Payer News .
Humana KentuckyHumana · 14 signals · last 30 days -
Fairview sues UnitedHealthcare over alleged Medicare Advantage false advertising
Minneapolis-based Fairview Health Services filed a lawsuit Oct. 1 against UnitedHealthcare, alleging false advertising with the insurer’s 2027 Medicare Advantage plans. The complaint, filed in Minnesota federal court, said Fairview decided in June to not renew its contract with UnitedHealthcare’s MA plans for 2027. However, the lawsuit said UnitedHealthcare has falsely presented that Fairview would […] The post Fairview sues UnitedHealthcare over alleged Medicare Advantage false advertising a...
UnitedHealthcare MinnesotaUnitedHealthcare · 47 signals · last 30 days -
‘We’re really trying to build something new’: Inside the Walmart-SCAN co-branded Medicare Advantage plans
SCAN Health Plan has been expanding its co-branded Medicare Advantage plans for 2027, including through a partnership with Walmart. Walmart and SCAN are launching the SCAN Walmart Health Advantage HMO and SCAN Walmart Medicare Complete Chronic Special Needs Plan, also known as a C-SNP, according to an Oct. 7 news release. The plans will be […] The post ‘We’re really trying to build something new’: Inside the Walmart-SCAN co-branded Medicare Advantage plans appeared first on Becker's Payer Iss...
SCANSCAN Health Plan · 13 signals · last 30 days -
Texas attorney general investigates UnitedHealth over care denials
Ken Paxton is on the hunt for evidence that UnitedHealth is breaking the Deceptive Trade Practices Act and other Texas laws, citing “alarming reports” of denied care.
UnitedHealth TexasUnitedHealthcare · 47 signals · last 30 days -
A health insurance agency’s journey from pilot to full-time voice AI agent
After struggling with high call volume — especially during Medicare open enrollment — eHealth turned to voice AI agents for help.
eHealtheHealth · 2 signals · last 30 days -
Judge rejects Alignment’s bid to toss former exec’s whistleblower lawsuit
A federal judge has largely rejected Alignment Healthcare’s bid to throw out a former senior executive’s whistleblower lawsuit that accuses the Medicare Advantage insurer of financial mismanagement. Alignment’s former chief technology officer, Hakan Kardes, PhD, alleged in July that he was pushed out of the company after reporting that it had misclassified $8 million to […] The post Judge rejects Alignment’s bid to toss former exec’s whistleblower lawsuit appeared first on Becker's Payer Issu...
Alignment HealthcareAlignment Healthcare · 3 signals · last 30 days -
Lawmakers press CMS to roll back proposed restrictions on remote patient monitoring
A bipartisan group of 32 House lawmakers is pressing CMS Administrator Mehmet Oz to reconsider proposed Medicare payment rule changes that would restrict how remote patient monitoring services are staffed and delivered.
Policy / Regulatory Changes · 140 signals · last 30 days -
SCAN, Sutter Health expand service area for co-branded Medicare Advantage plans
SCAN Health Plan and Sacramento, Calif.-based Sutter Health are bringing their co-branded Medicare Advantage plans to four more Northern California counties in 2027, up from six in 2026. SCAN and Sutter first announced their collaboration in 2025, with Sutter hinting at possible future expansion beyond the region. According to a SCAN news release from Oct. […] The post SCAN, Sutter Health expand service area for co-branded Medicare Advantage plans appeared first on Becker's Payer Issues | Pay...
SCAN CaliforniaSCAN Health Plan · 13 signals · last 30 days -
Molina assumes $6B Florida Medicaid, CHIP special contract
Molina Healthcare took over the contract for a specialized Florida Medicaid and CHIP plan, previously managed by Centene’s Sunshine Health, on Oct. 1. Molina first announced it had secured the contract in November 2025, but the start date had not been confirmed. At the time, Molina expected to serve roughly 120,000 enrollees of the Title […] The post Molina assumes $6B Florida Medicaid, CHIP special contract appeared first on Becker's Payer Issues | Payer News .
Centene + Molina Healthcare · 16 signals · last 30 days -
Some mental health providers hoping to serve Lane County's Oregon Health Plan members say they’re facing barriers
Some mental health providers hoping to serve Lane County's Oregon Health Plan members say they’re facing barriers Several providers said they faced contract issues with Trillium, a subsidiary of the Centene Corporation that administers the state's Medicaid program in Lane County Joanne Zuhl Tue, 10/06/2026 - 10:15 At Aspire Wellness, a new outpatient behavioral health clinic in Springfield, there are sensory rooms, classrooms for group therapy and ample space for walk-ins. Aspire will serve a...
Centene OregonCentene · 13 signals · last 30 days