Payers have faced state penalties in 2025 for slow reimbursements, improper claims denials, and mental health parity violations. Fines in ...

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 ...

UnitedHealth Group is complying with criminal and civil investigations into its Medicare Advantage business, the company said in a July 24 regulatory filing. The disclosure comes after The Wall Street ...

"Discover the latest workforce reduction efforts and job eliminations in the insurance industry for 2025, including layoffs at major payers like BCBS and Aetna.

CMS is implementing a final rule that will shorten the open enrollment period on the ACA exchange and create stricter eligibility verifications for enrollees. In a June 20 news release, the agency ...

Medicare Advantage insurer Devoted Health has laid off 120 employees, a small percentage of its more than 2,000 employees. “Devoted Health’s recent workforce changes are in line with our ongoing ...

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.

Payer leaders need a flexible mindset, data know-how and big-picture thinking to succeed in 2025, according to more than a dozen executives. Becker’s reached out to 17 executives to learn what ...

Aligning wound patient needs with the appropriate level of care can have a significant impact on patients, hospitals, and payors. In one recent case study, two hospitals reduced wound patients’ ...

July 28, 2025 1. RFK Jr. reportedly threatens to fire preventive care task force Full story 2. Molina CFO: 'A lot of errors' in Medicaid, ACA duplicative enrollment estimates Full story 3. Your ...

CMS issued its final 2025 Medicare Advantage and Part D rule April 4, setting new standards around marketing, broker payments, and prior authorization.

In five large counties, payers own more than one-third of the primary care market, according to a study published in the July issue of Health Affairs Scholar found. Payers, including Optum, Aetna, ...