Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
722 signals
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Epic releases Care Everywhere diagnostic image exchange to tackle healthcare's 'CD problem'
Epic released a new diagnostic image exchange solution that enables healthcare providers at Epic-connected health systems to retrieve and share diagnostic-quality medical images, such as CT scans, X-rays and MRIs, with a single click.
SCANSCAN Health Plan · 11 signals · last 30 days -
Cityblock unveils partnership with Humana in North Carolina
Cityblock Health is expanding its footprint in North Carolina through a new partnership with Humana.
Humana North CarolinaHumana · 13 signals · last 30 days -
Medicaid Program; Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children
This final rule requires that a State Medicaid plan must provide that the Medicaid agency will not make payment under the plan for sex-rejecting procedures for children under 18, and prohibits the use of Federal Medicaid dollars to fund sex-rejecting procedures for individuals under the age of 18. In addition, this final rule requires that a separate State Children's Health Insurance Program (CHIP) plan must provide that the CHIP agency will not make payment under the plan for sex-rejecting p...
Policy / Regulatory Changes · 67 signals · last 30 days -
Medicare Program; Alternative Payment Model (APM) Incentive Payment Advisory for Clinicians-Request for Current Billing Information for Qualifying APM Participants
This advisory is to alert certain clinicians who are Qualifying Alternative Payment Model (APM) participants (QPs) and eligible to receive an APM Incentive Payment that the Centers for Medicare & Medicaid Services (CMS) does not have the current billing information needed to disburse the payment. This advisory provides information to these clinicians on how to update their billing information to receive this payment for the 2026 payment year.
Policy / Regulatory Changes · 67 signals · last 30 days -
56% of employers using Big 3 PBMs consider switch
Fifty-six percent of employer clients of “Big Three” pharmacy benefit managers — CVS Caremark, Cigna’s Express Scripts and UnitedHealth Group’s Optum Rx — are thinking about switching in the next one to three years. The 2026 “Pulse of the Purchaser” survey, released Aug. 11 by the National Alliance of Healthcare Purchaser Coalitions, included 408 responses […] The post 56% of employers using Big 3 PBMs consider switch appeared first on Becker's Payer Issues | Payer News .
UnitedHealthOptumUnitedHealthcare · 34 signals · last 30 days -
CMS finalizes ban on Medicaid, CHIP funding for gender-affirming care provided to children
The Centers for Medicare & Medicaid Services yesterday released a final rule that prohibits states from receiving federal matching funds for “sex-rejecting procedures” for Medicaid beneficiaries under the age of 18, and for Children’s Health Insurance Program beneficiaries in certain states under the age of 19. The final rule does not prevent states from providing coverage for these services with state-only funds. CMS said that federal Medicaid and CHIP funding will be available for a taperin...
Policy / Regulatory Changes · 67 signals · last 30 days -
Oscar flags up to 300K ACA disenrollments tied to CMS fraud crackdown
Oscar Health expects between 250,000 and 300,000 of its marketplace members to be retroactively disenrolled in connection with CMS program integrity initiatives and fraud, waste and abuse enforcement, the insurer disclosed Aug. 7. The expected disenrollments represent roughly 8% to 10% of Oscar’s total membership, which stood at approximately 2.96 million as of June 30. […] The post Oscar flags up to 300K ACA disenrollments tied to CMS fraud crackdown appeared first on Becker's Payer Issues |...
Oscar HealthOscar Health · 2 signals · last 30 days -
CMS requests updated billing information from qualifying alternative payment model participants to disburse payment
The Centers for Medicare & Medicaid Services today released an advisory for certain clinicians who are qualifying alternative payment model participants and eligible to receive APM incentive payments, notifying them that their current billing information must be updated to receive funds for the 2026 payment year. CMS said that it was unable to identify a taxpayer identification number associated with some participants after processing 2026 APM incentive payments and therefore was unable to di...
Policy / Regulatory Changes · 67 signals · last 30 days -
UnitedHealth sets quarterly dividend
UnitedHealth Group’s board of directors approved a per-share cash dividend of $2.32 to be paid Sept. 22. The dividend will be paid to all shareholders of the company’s common stock as of business close on Sept. 14. The company released its second-quarter earnings July 16, posting nearly $5.5 billion in profit. UnitedHealth boosted its full-year […] The post UnitedHealth sets quarterly dividend appeared first on Becker's Payer Issues | Payer News .
UnitedHealthUnitedHealthcare · 34 signals · last 30 days -
Elevance-backed physician group, Franciscan Alliance partner in value-based care push
Mishawaka, Ind.-based Franciscan Alliance has partnered with Millennium Physician Group to expand value-based care and primary care access across Indiana. Fort Myers, Fla.-based Millennium is part of a national value-based care platform partially owned by Elevance Health. The partnership will combine Franciscan’s physician network with Millennium’s practice management, analytics and value-based care capabilities. Franciscan physicians […] The post Elevance-backed physician group, Franciscan A...
Elevance IndianaElevance Health · 11 signals · last 30 days -
Trump administration cuts Medicaid funding for youth gender-affirming care
CMS Administrator Dr. Mehmet Oz argues the rule will protect children from "irreversible harm." LGBTQ+ advocates say the rule is an attack on transgender youth.
Policy / Regulatory Changes · 67 signals · last 30 days -
Years After He Quit Smoking, a Lung Cancer Scan Saved His Life
Lung cancer remains the leading cause of cancer deaths in the United States, and older adults are at higher risk. But only about a quarter of patients eligible for screening are up to date.
SCANSCAN Health Plan · 11 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 -
CMS ends Medicaid, CHIP funding for gender-affirming care for minors
The Trump administration has finalized a rule that would pull funding for gender-affirming care for minors from Medicaid and the Children's Health Insurance Program.
Policy / Regulatory Changes · 67 signals · last 30 days -
Trump administration finalizes rule restricting trans healthcare for minors on Medicaid
The Trump administration on Tuesday released a final rule blocking the use of federal Medicaid dollars for transgender healthcare for minors, as well as barring Children’s Health Insurance Program (CHIP) plans from paying for gender-affirming procedures for minors. The final rule released by The Centers for Medicare and Medicaid Services (CMS) bars Medicaid dollars from...
Policy / Regulatory Changes · 67 signals · last 30 days -
CMS Ends Federal Medicaid and CHIP Funding for Sex-Rejecting Procedures for Children and Youth
CMS Ends Federal Medicaid and CHIP Funding for Sex-Rejecting Procedures for Children and Youth The Centers for Medicare & Medicaid Services (CMS) is implementing an administration priority consistent with its commitment to protect children from experimental and life-altering sex-rejecting procedures that carry serious long-term health risks and lack sufficiently reliable evidence of clinical benefit. The final rule ends the use of federal Medicaid and CHIP funds to pay for these procedures on...
Policy / Regulatory Changes · 67 signals · last 30 days -
BCBS Association fends off most claims in data-tracking suit
A federal judge dismissed most of a class-action lawsuit alleging the Blue Cross Blue Shield Association shared federal employees’ health-related website data with TikTok, Meta, Google and LinkedIn without consent. The lawsuit dates back to 2023. A January 2024 amended complaint from federal employees and retirees said BCBS supplies health coverage to more than 5.5 […] The post BCBS Association fends off most claims in data-tracking suit appeared first on Becker's Payer Issues | Payer News .
Blue CrossBlue ShieldBlue Cross Blue Shield plans · 20 signals · last 30 days -
CMS' mandatory VBC programs brought substantial administrative costs for hospitals: study
Four mandatory value-based payment programs were associated with more than $3 billion in aggregated administrative costs compared to non-participating hospitals, researchers' analysis of Medicare cost reports found.
Policy / Regulatory Changes · 67 signals · last 30 days -
Alignment secures $200M credit line as it eyes plan acquisitions
Medicare Advantage insurer Alignment Health is expecting to grow into new markets and carry out acquisitions — and now has the financial backing to do so. The insurer laid out its plan in a July 30 Securities and Exchange Commission filing. Alignment anticipates acquiring healthcare delivery groups in targeted geographies, standalone and provider-sponsored MA plans, […] The post Alignment secures $200M credit line as it eyes plan acquisitions appeared first on Becker's Payer Issues | Payer Ne...
Competitive / Operational Strategy · 38 signals · last 30 days -
Texas’ ACA enrollment ‘boom’ didn’t happen after all
Not all CMS data is telling the same story when it comes to ACA enrollment in Texas. As of January, nearly 4.2 million Texans had selected ACA plans for 2026, up from nearly 4 million in 2025. That marked the largest enrollment increase of any state. A previous KFF analysis found Texas had the highest […] The post Texas’ ACA enrollment ‘boom’ didn’t happen after all appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 67 signals · last 30 days -
UnitedHealth paid $3B for benefits platform Alegeus
UnitedHealth Group paid $3 billion for benefits administration platform Alegeus, according to an Aug. 10 filing with the Securities and Exchange Commission. The company had not previously disclosed a price for the deal. In the filing, which does not directly name Alegeus, UnitedHealth said it entered an agreement in the first quarter to acquire a […] The post UnitedHealth paid $3B for benefits platform Alegeus appeared first on Becker's Payer Issues | Payer News .
UnitedHealthUnitedHealthcare · 34 signals · last 30 days -
BCBS Illinois exec to depart for kidney foundation’s CEO role
William Crowley, BSN, executive director of clinical operations for Health Care Service Corp.’s Blue Cross Blue Shield of Illinois, will join the National Kidney Foundation of Illinois as CEO Aug. 24. Over his 25-plus-year career, Mr. Crowley has held senior leadership and director roles at UnitedHealth Group’s Optum Health, as well. He has also worked […] The post BCBS Illinois exec to depart for kidney foundation’s CEO role appeared first on Becker's Payer Issues | Payer News .
UnitedHealthcare · 34 signals · last 30 days -
STAT+: A RAPID proposal for breakthrough coverage, and nurses push back on AI
In this edition of STAT Health Tech: Details from CMS and FDA on the RAPID pathway for breakthrough devices, and nurses push back on AI.
Policy / Regulatory Changes · 67 signals · last 30 days -
Why Molina Healthcare keeps stumbling in the ACA exchanges
Molina Healthcare's second-quarter performance contrasted with rivals Elevance Health, Centene and Oscar Health.
ElevanceCenteneElevance Health + Centene · 21 signals · last 30 days -
Humana taps ex-Johns Hopkins exec as Medicaid leader
James “J.P.” Holland is taking the reins of Humana’s Medicaid business, a key growth area for the company, starting this coming Monday. It’s part of a broader leadership transition announced late last year.
HumanaHumana · 13 signals · last 30 days