News

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 ...
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 ...
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’ ...
New York City-based NewYork-Presbyterian could go out of network with Aetna if the sides are unable to reach a new contract agreement by March 31, The Journal News reported March 12. From the fallout ...
Humana executives said the cyberattack on Change Healthcare is making it harder for payers to gauge their medical expenses, Bloomberg reported March 5. Centene's canceled East Coast headquarters in ...
Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. CentraCare, based ...
GAO investigates PPACA subsidies and abortion coverage: 3 things to know Many health insurers have disregarded regulations meant to keep health insurance subsidies distributed under the Patient ...
UnitedHealth Group cybersecurity incident not expected to affect ratings: Fitch, Moody's UnitedHealth Group's Change Healthcare reported a cybersecurity incident Feb. 21 that disrupted connectivity ...
Preparing for regulatory changes, investing in AI and technology and improving member experiences are among the top priorities for payer executives in the second half of 2025. Becker’s checked in with ...
A former Medicare Advantage executive has been found not guilty of healthcare fraud. A jury found Kenia Valle Boza, the former director of Medicare risk adjustment analytics for HealthSun Health Plans ...