Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
1203 signals
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Sentara wraps Anthem negotiations for MA, Medicaid, ACA plans without deal
Norfolk, Va.-based Sentara Health ended negotiations with Anthem Blue Cross and Blue Shield of Virginia on 2027 contract extensions for Medicare Advantage, Medicaid and ACA exchange plans. An Oct. 5 update on Sentara’s website said the health system set an Oct. 1 deadline for Anthem to agree on proposals, but the parties were unable to […] The post Sentara wraps Anthem negotiations for MA, Medicaid, ACA plans without deal appeared first on Becker's Payer Issues | Payer News .
Elevance Health + Blue Cross Blue Shield plans · 48 signals · last 30 days -
UnitedHealth Group in the headlines: 12 updates
From a Texas attorney general investigation to a leadership shakeup that includes a new UnitedHealthcare president, here are 12 updates on UnitedHealth Group and its subsidiaries that Becker’s has reported since Sept. 14: 1. Texas Attorney General and U.S. Senate candidate Ken Paxton launched an investigation into UnitedHealth Group, stemming from allegations of “deceptive and […] The post UnitedHealth Group in the headlines: 12 updates appeared first on Becker's Payer Issues | Payer News .
UnitedHealthcare · 47 signals · last 30 days -
CMS releases list of participants in CJR-X payment model for joint replacement procedures
The Centers for Medicare & Medicaid Services has published its list of participants for its mandatory Comprehensive Care for Joint Replacement Expanded Model, or CJR-X. The payment model focuses on lower extremity joint replacement procedures. CMS is requesting participating hospitals to complete the online primary point of contact form and identify two individuals to serve as their primary points of contact for CJR-X-related communications from the agency. The model, which initially ran in s...
Policy / Regulatory Changes · 140 signals · last 30 days -
UnitedHealthcare to exit Georgia’s ACA marketplace in 2027
UnitedHealthcare is exiting Georgia’s ACA marketplace Jan. 1, 2027, the insurer and Georgia’s Office of the Commissioner of Insurance and Safety Fire confirmed to Becker’s Oct. 6. “We remain committed to serving members throughout the transition and will continue providing health coverage to Georgians through our off-exchange individual and family plans, as well as our […] The post UnitedHealthcare to exit Georgia’s ACA marketplace in 2027 appeared first on Becker's Payer Issues | Payer News .
UnitedHealthcare GeorgiaUnitedHealthcare · 47 signals · last 30 days -
The healthiest states for women, children in 2026: UnitedHealth
Massachusetts is the healthiest state in the nation for women and children for the second consecutive year, while Louisiana again ranks last, according to the United Health Foundation’s “2026 America’s Health Rankings Health of Women and Children Report” published Oct. 6. The 10th anniversary edition of the report evaluates all 50 states across 83 measures […] The post The healthiest states for women, children in 2026: UnitedHealth appeared first on Becker's Payer Issues | Payer News .
UnitedHealthcare · 47 signals · last 30 days -
Cigna targets ‘inefficient’ spending with clinical support model rollout
Cigna Healthcare is launching Health Sense, a tailored customer and clinical support model that unifies health, benefits and cost information, in early 2027. Health Sense will be embedded across the Cigna experience, instead of operating as a standalone resource. The model will bring together member context, surface that context to Cigna clinical and care teams […] The post Cigna targets ‘inefficient’ spending with clinical support model rollout appeared first on Becker's Payer Issues | Payer...
CignaCigna · 15 signals · last 30 days -
Before Saying Yes to the Medical Test, Know the Risks and Benefits
Tests like full-body scans marketed directly to consumers are pitched as a way to detect diseases early and establish a baseline of health markers. But there are financial, physical, and psychological risks to all medical tests — and in some cases, not getting a test could be better for your health.
SCANSCAN Health Plan · 13 signals · last 30 days -
Rural Health Transformation Program: Early Implementation Actions and Monitoring Plans
What GAO Found The Rural Health Transformation program provides funding for states to conduct rural health activities, such as recruiting clinicians to rural areas and providing training and technology to improve care delivery in rural hospitals. In the latter half of 2025, the Centers for Medicare & Medicaid Services (CMS) completed a number of early key actions to implement the Rural Health Transformation program. These actions included the release of the notice of funding opportunity—which...
Policy / Regulatory Changes · 140 signals · last 30 days -
Independence Blue Cross to pay $22.5M in Medicare Advantage inaccurate diagnoses allegations settlement
The settlement resolves allegations from 2017 to 2021 that the company submitted “inaccurate and untruthful” diagnoses data to CMS.
Blue CrossBlue Cross Blue Shield plans · 36 signals · last 30 days -
CMS finalizes updates to price transparency regulations that aim to improve usability
The Trump administration on Monday finalized a rule that aims to make the data files mandated under price transparency regulations more usable.
Policy / Regulatory Changes · 140 signals · last 30 days -
FTC sends price transparency warning letters to 24 large hospital systems
Letters sent Monday warn that CMS guidances on price transparency are "a regulatory floor." Hospitals are also subject to the FTC Act's prohibitions on unfair or deceptive marketplace practices, which could apply to incomplete or inaccurate pricing information, the regulator said.
Policy / Regulatory Changes · 140 signals · last 30 days -
Texas AG Ken Paxton launches investigations into UnitedHealth Group, BCBSTX
Texas Attorney General Ken Paxton announced on Monday that he would launch an investigation into industry giant UnitedHealth Group for "engaging in deceptive and unlawful practices" that may have denied care to Texans.
UnitedHealth TexasUnitedHealthcare · 47 signals · last 30 days -
New Regulations Make It Easier to Find, Compare, and Report Healthcare Pricing and Coverage Information
New Regulations Make It Easier to Find, Compare, and Report Healthcare Pricing and Coverage Information
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HCSC halved its Medicare Advantage footprint but says it’s still playing the long game
Health Care Service Corp. has cut its Medicare Advantage footprint in half less than two years after buying Cigna’s Medicare business for $3.3 billion, but the Chicago-based insurer says the narrowed focus will allow it to achieve sustainable growth over time. The company is coming off a costly year, posting a net loss of more […] The post HCSC halved its Medicare Advantage footprint but says it’s still playing the long game appeared first on Becker's Payer Issues | Payer News .
CignaCigna · 15 signals · last 30 days -
Texas investigates UnitedHealth over care denial concerns
Texas Attorney General and U.S. Senate candidate Ken Paxton has launched an investigation into UnitedHealth Group. An Oct. 5 news release said the investigation resulted from allegations of “deceptive and unlawful practices” that could have denied Texans medically necessary care. Mr. Paxton’s office said there had been reports alleging the company “bribed nursing homes to […] The post Texas investigates UnitedHealth over care denial concerns appeared first on Becker's Payer Issues | Payer News .
UnitedHealth TexasUnitedHealthcare · 47 signals · last 30 days -
STAT+: Judges skewer HHS arguments in hearing over Medicare Advantage audits lawsuit
Federal judges pushed back against the government's arguments in a Medicare Advantage case.
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UnitedHealthcare sued over copay accumulator policy
UnitedHealthcare is facing a class-action lawsuit, which alleges the insurer inappropriately stopped crediting payments funded by drug manufacturer assistance toward a member’s deductible and out-of-pocket limit, according to a Sept. 30 complaint in a Connecticut federal court. The complaint, from a UnitedHealthcare member, said his plan has a $7,550 deductible and annual out-of-pocket limit before […] The post UnitedHealthcare sued over copay accumulator policy appeared first on Becker's Pay...
UnitedHealthcare ConnecticutUnitedHealthcare · 47 signals · last 30 days -
CMS finalizes price transparency overhaul for payers
The Trump administration is overhauling federal price transparency rules for payers and self-insured employers, including cutting so-called “ghost rates,” expanding out-of-network price disclosures and requiring executives to vouch for the accuracy of the data. The final rule, released Oct. 5 by CMS and the Labor and Treasury departments, revises the price transparency regulations first finalized […] The post CMS finalizes price transparency overhaul for payers appeared first on Becker's Paye...
Policy / Regulatory Changes · 140 signals · last 30 days -
CMS flags payment delays, rising costs in No Surprises Act arbitration
CMS is raising concerns about growing costs and payment problems in the federal independent dispute resolution process created by the No Surprises Act and met with every certified independent dispute resolution entity Oct. 1 to talk about possible changes. CMS Administrator Mehmet Oz, MD, Department of Labor Assistant Secretary Daniel Aronowitz, and officials from HHS, […] The post CMS flags payment delays, rising costs in No Surprises Act arbitration appeared first on Becker's Payer Issues |...
Policy / Regulatory Changes · 140 signals · last 30 days -
BCBS Minnesota cuts most Medicare Advantage plans following $500M loss
Blue Cross and Blue Shield of Minnesota is discontinuing most of its Medicare Advantage plans at the end of 2026, citing more than $500 million in Medicare losses over the past three years amid rising medical and pharmacy costs. “While I am reassured that our financial foundation remains strong, that does not mean we can […] The post BCBS Minnesota cuts most Medicare Advantage plans following $500M loss appeared first on Becker's Payer Issues | Payer News .
Blue Cross Blue Shield plans · 36 signals · last 30 days -
AHA blog responds to BCBS report suggesting hospitals’ use of AI documentation tools drives increased healthcare costs
An AHA blog published Oct. 5 responds to a Blue Cross Blue Shield Association report suggesting that hospitals’ use of artificial intelligence-enabled documentation tools is driving higher healthcare costs through increased coding intensity. “Correctly assessing the clinical status of a patient is imperative to delivering high-quality care,” write Molly Smith, AHA group vice president of policy, and Jen Holloman, AHA director of health IT policy. “Patients today are older and more clinically...
Blue CrossBlue ShieldBlue Cross Blue Shield plans · 36 signals · last 30 days -
Transparency in Coverage Final Rules (CMS 9882-F)
Transparency in Coverage Final Rules (CMS 9882-F) Introduction
Policy / Regulatory Changes · 140 signals · last 30 days -
Trump to send $90 payments to 20 million Medicare enrollees
The White House said the federal government will send more than 20 million Medicare enrollees one-time $90 payments to help with Part B premiums in early October. An Oct. 2 White House fact sheet said the payments would come from the Medicare Improvement Fund, which was established in 2008 to strengthen fee-for-service Medicare Parts A […] The post Trump to send $90 payments to 20 million Medicare enrollees appeared first on Becker's Payer Issues | Payer News .
Financial / Operating Pressure · 31 signals · last 30 days -
House Committee Report on Fraud Against Medicare and Medicaid: Oversight Done Wrong
On September 29, exactly five weeks before the mid-term elections, Republicans on the House Energy & Commerce Committee released a Majority Staff Report on fraud against Medicare and Medicaid. The same day the Committee’s Chairman announced a package of 14 bills, 13 of which would amend the Medicaid statute to address fraud against the program. At […]
Policy / Regulatory Changes · 140 signals · last 30 days -
The Trump Administration’s $90 Payment to Medicare Beneficiaries, Reminiscent of a Similar Proposal Six Years Ago, May Not Offset Rising Costs
Medicare’s standard Part B premium is $2,435 this year and is projected to increase by $79 annually for 2027 – meaning this increase alone would consume most of the $90 payment, which less than half of all beneficiaries will receive.
Financial / Operating Pressure · 31 signals · last 30 days