During a featured session at Becker’s 3rd Annual Payer Issues Roundtable, Bob Tavernier, Sales Solutions Executive with Quest Analytics®, and Karen Tachian, Senior Director of Network Regulatory ...

Federal lawmakers have introduced a handful of bills aimed at speeding up prior authorization and cracking down on upcoding in Medicare Advantage. None of the introduced bills have been heard in ...

Louisiana Gov. Jeff Landry has vetoed a key provision from the state’s budget plan that would have required coverage of weight loss medications for state employees and their dependents for the ...

The Trump administration and insurers appear to have their own changes to reimbursement practices in store, with announcements expected next week — adding to funding changes outlined in Congress’ ...

CMS will raise limits for payments to Medicare Advantage brokers for 2026. According to a notice from CMS published June 18, plans can pay brokers up to $694 for new enrollments in MA plans, and $347 ...

Medicare Advantage enrollees experience longer hospital stays before being discharged to post-acute care settings compared to individuals enrolled in traditional Medicare, according to a June 2025 ...

Cigna Healthcare offers the best digital experience to commercial members, while UPMC Health Plan provides the best experience to Medicare Advantage enrollees, according to J.D. Power’s 2025 U.S.

UnitedHealthcare and Cigna Healthcare are facing lawsuits from members or their families alleging the organizations use automated data tools to wrongfully deny members’ medical claims. The allegations ...

The remainder of the reductions will occur Nov. 1, according to an Aug. 1 post on UnitedHealthcare’s website. The prior authorization code eliminations will take place on Sept. 1 and Nov. 1 for ...

Patient expectations will push healthcare to evolve by 2030, according to 23 payer executives. Leaders said AI, new models of care and a push toward convenience will transform healthcare in the next ...

Six things to know about the two-midnight rule and how it applies to Medicare Advantage: 1. In the 2014 Medicare inpatient prospective payment system final rule, CMS included a new regulation for ...

CMS is considering proposals that would cut the number of procedures that are subject to prior authorization, Bloomberg reported April 29. Five things to know: 1. People familiar with the discussions ...