Industry News

Below are 20 recent industry news stories procured from a host of different sources. Unified Growth Partners / Coverage Champs / Medicare Champs does not endorse any views reported in these stories. 

News Headlines & Summaries

• Headline: UnitedHealth to Drop Over 100 Medicare Advantage Plans in 2026
  URL: https://www.reuters.com/legal/litigation/unitedhealth-exit-medicare-advantage-plans-16-us-counties-2025-10-01/
  Summary: UnitedHealth announced it will discontinue Medicare Advantage plans in 109 U.S. counties in 2026, affecting approximately 180,000 members. The decision is attributed to rising healthcare costs and reimbursement pressures in the insurance program.

• Headline: Humana Sees 20% of Its Members in High-Rated Medicare Plans for 2026
  URL: https://www.reuters.com/business/healthcare-pharmaceuticals/humana-sees-20-its-members-high-rated-medicare-plans-2025-10-02/
  Summary: Humana reports that 20% (about 1.2 million) of its members are enrolled in Medicare Advantage plans rated 4 stars and above for 2026. The company also noted a significant increase in members enrolled in 4.5-star plans—rising from 3% in 2025 to 14% in 2026.

• Headline: Democratic AGs Lose Bid to Halt ACA Marketplace Changes
  URL: https://www.reuters.com/legal/government/democratic-ags-lose-bid-halt-aca-marketplace-changes-2025-10-02/
  Summary: A coalition of 20 Democratic attorneys general and Pennsylvania Governor Josh Shapiro failed in their effort to halt parts of a new U.S. Department of Health and Human Services (HHS) rule revising Affordable Care Act (ACA) marketplace criteria. U.S. District Judge Nathaniel Gorton ruled against a preliminary injunction, stating that the plaintiffs’ concerns about increased healthcare costs and a predicted drop of up to 1.8 million in enrollment were exaggerated and largely speculative.

• Headline: New Mexico Legislature Approves Bills to Prop Up Rural Health Care, Underwrite Food Assistance
  URL: https://apnews.com/article/163f62bff8bf2efe4cc5323b0f5424af
  Summary: During a special legislative session, the New Mexico Legislature approved a series of funding measures aimed at counteracting federal cuts made by President Donald Trump's administration to Medicaid and food assistance programs. The actions include over $16 million to support the Supplemental Nutrition Assistance Program (SNAP), especially for elderly recipients and noncitizens affected by tightened eligibility requirements.

• Headline: America's Senseless Government Shutdown
  URL: https://www.ft.com/content/9e8f0576-5f6e-4b0a-9238-56b4e1d5a0f4
  Summary: The article discusses the October 2025 U.S. government shutdown, the first in seven years, triggered by a political impasse over healthcare subsidies under the Affordable Care Act. Approximately 750,000 federal workers were furloughed.

• Headline: Medicare Users Could Soon Lose Perks They Love
  URL: https://www.marketwatch.com/story/medicare-changes-could-delay-or-deny-healthcare-demand-prior-approvals-for-treatment-8f25dc55
  Summary: The Centers for Medicare and Medicaid Services (CMS) plans to shift all traditional Medicare beneficiaries into cost-saving accountable care organizations (ACOs) by 2030. These ACOs, formed by networks of doctors and hospitals, are financially rewarded for meeting budget targets and penalized for overspending.

• Headline: October 1, 2025 Federal Government Shutdown: Impact on HHS Operations
  URL: https://foleyhoag.com/news-and-insights/publications/alerts-and-updates/2025/october/what-the-october-1-2025-federal-government-shutdown-means-for-hhs-operations/
  Summary: At 12:01 a.m. on October 1, 2025, the federal government entered a shutdown. The Food and Drug Administration (FDA) and Centers for Medicare & Medicaid Services (CMS), among other parts of The Department of Health and Human Services (HHS), are not fully closed, but are operating in a limited capacity under HHS’s FY 2026 contingency plan and the Anti-Deficiency Act.

• Headline: Federal Shutdown Disrupts Telehealth; Medicare and Medicaid Payments Continue
  URL: https://www.cmadocs.org/newsroom/news/view/ArticleId/50995/Federal-shutdown-disrupts-telehealth-Medicare-and-Medicaid-payments-continue
  Summary: The federal government shutdown has disrupted telehealth services, but Medicare and Medicaid payments continue, with a 10-day temporary hold on claims affected by expired programs.

• Headline: CMS Should Revise Pay Proposals to Strengthen Private Practice
  URL: https://www.ama-assn.org/practice-management/medicare-medicaid/cms-should-revise-pay-proposals-strengthen-private-practice
  Summary: The American Medical Association (AMA) urges the Centers for Medicare & Medicaid Services (CMS) to revise its proposed 2026 Medicare Physician Fee Schedule to strengthen private practice. The AMA emphasizes the need for fair compensation and support for physicians to ensure continued access to quality care for Medicare beneficiaries.

• Headline: Tracking the Medicaid Provisions in the 2025 Federal Budget Bill
  URL: https://www.kff.org/medicaid/tracking-the-medicaid-provisions-in-the-2025-budget-bill/
  Summary: Kaiser Family Foundation provides an overview of the Medicaid provisions in the 2025 federal budget bill, including new Medicaid work and verification requirements and a reduction in the federal Medicaid matching rate. These changes are expected to impact Medicaid enrollment and state budgets.

• Headline: Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2026
  URL: https://www.cms.gov/newsroom/press-releases/medicare-advantage-medicare-prescription-drug-programs-expected-remain-stable-2026
  Summary: The Centers for Medicare & Medicaid Services (CMS) announced that average premiums, benefits, and plan choices for Medicare Advantage and the Medicare Part D prescription drug program are expected to remain stable in 2026. CMS encourages beneficiaries to review their options during the upcoming open enrollment period.

• Headline: Health Insurance Renewals Reach Record High in FY26
  URL: https://timesofindia.indiatimes.com/business/india-business/health-insurance-renewals-reach-record-high-in-fy26-heres-why-people-are-opting-for-it/articleshow/124209833.cms
  Summary: Health insurance renewals in India have reached record highs in FY26, thanks to the rising popularity of modular, affordable, and high-cover policies. A report by Policybazaar shows that over the past two years, plans designed with consumer convenience in mind have made health insurance more accessible than ever.

• Headline: Critical Illness Insurance in 2025: Everything You Need to Know Before You Buy
  URL: https://www.moneycontrol.com/news/business/personal-finance/critical-illness-insurance-in-2025-everything-you-need-to-know-before-you-buy-13595518.html
  Summary: Critical illness insurance provides a lump sum amount upon diagnosis of certain diseases, covering treatment, recovery, and lifestyle changes. This type of insurance complements regular health insurance by offering financial support during critical health events.

• Headline: Private Insurers Cut Agent Commissions After GST Changes on Health Cover
  URL: https://www.business-standard.com/finance/insurance/icici-lombard-care-health-aditya-birla-cut-commissions-post-gst-125100101265_1.html
  Summary: ICICI Lombard, Care Health, and Aditya Birla Health Insurance have lowered commission payouts on retail policies following the Goods and Services Tax (GST) exemption on health premiums. This adjustment aims to offset the impact of the GST changes on the insurers' revenue streams.

• Headline: No Cashless Claim for Tata AIG Health Insurance Policyholders in Max Hospitals
  URL: https://economictimes.indiatimes.com/wealth/insure/no-cashless-claim-for-tata-aig-for-health-insurance-policyholders-in-max-hospitals-becomes-4th-insurer-to-do-so/articleshow/124150088.cms
  Summary: Tata AIG Insurance stopped cashless claims at Max Hospitals from September 10, 2025, following similar actions by Star Health, Niva Bupa, and CARE Health. Max Hospitals claims that Tata AIG demanded lower rates after a signed agreement, while Tata AIG assures customers of reimbursement through reimbursement claims.

• Headline: Tens of Thousands of Vermonters Set to Lose Medicare Advantage Plans in 2026
  URL: https://vtdigger.org/2025/10/01/tens-of-thousands-vermonters-are-set-to-lose-medicare-advantage-option-in-2026/
  Summary: New data from the Centers for Medicare & Medicaid Services reveal that nearly all Medicare Advantage providers in Vermont will discontinue coverage for 2026, leaving tens of thousands of beneficiaries without their current plans. Only one provider is expected to continue offering coverage, prompting concerns about access to care and potential disruptions for enrollees.

• Headline: Government Shutdown Disrupts Telehealth; Medicare and Medicaid Payments Continue
  URL: https://www.cmadocs.org/newsroom/news/view/ArticleId/50995/Federal-shutdown-disrupts-telehealth-Medicare-and-Medicaid-payments-continue
  Summary: While Medicare and Medicaid payments will continue during the federal government shutdown, important programs expired on September 30, including pandemic-era telehealth waivers, community health center funding, and the National Health Service Corps. Physicians may continue providing telehealth care and billing Medicare for those services, but payments are being held and are not guaranteed.

• Headline: States Already Cutting Medicaid, Massive Federal Cuts Yet to Come
  URL: https://www.medicarerights.org/medicare-watch/2025/10/02/states-already-cutting-medicaid-massive-federal-cuts-yet-to-come
  Summary: States are already implementing Medicaid cuts in anticipation of significant federal reductions set to take effect in 2027. These early actions are raising concerns about access to care for low-income individuals and the potential strain on state budgets.

• Headline: CVS Health to Scale Back Medicare Advantage Offerings in 2026
  URL: https://www.reuters.com/legal/litigation/cvs-health-offer-2026-medicare-prescription-drug-plans-43-states-2025-10-01/
  Summary: CVS Health announced it will reduce its Medicare Advantage offerings in 2026, citing lower reimbursement rates and increased medical costs. The company plans to offer prescription drug plans in 43 states, down from the current 44.

• Headline: Humana Provides Early Look at Medicare Advantage Ratings for 2026
  URL: https://www.marketwatch.com/story/humana-provides-a-peak-into-its-medicare-advantage-plan-ratings-and-the-stock-jumps-9c8a2676
  Summary: Humana disclosed preliminary data indicating that 20% of its Medicare Advantage members will be enrolled in plans rated 4 stars or higher for 2026, with a significant increase in members enrolled in 4.5-star plans. The company's stock rose 4% following the announcement.