Payer Alert Roundup: September 2026

September was not a quiet month. Three of the largest payers in the country agreed to share credentialing infrastructure, several networks changed shape, and one federal deadline moved a quarter closer without moving at all.

Here is what landed, and what each item asks of you.

1. Three major payers agree to share credentialing

Announced September 23-24. Service planned for fall 2026.

CertifyOS launched a National Shared Credentialing Program with UnitedHealthcare, Cigna Healthcare and Centene as initial participants. Providers submit their information once through a single portal rather than separately to each payer. CertifyOS performs primary source verification to NCQA and state Medicaid standards and packages the result into a standardized profile the participating payers accept.

The stated rationale is hard to argue with. The US spends more than $2 billion a year verifying provider credentials, with industry estimates putting up to 75% of that cost — roughly $1.5 billion — down to duplication. Health plans spend between $200 and $500 per provider per recredentialing cycle running the same checks in parallel.

Two caveats worth carrying. The announcement does not describe whether the commitments are binding commercial agreements, how many providers are included, or which plans and specialties are in the first rollout, and there is no program outcome data yet because the service has not launched. Separately, the "first of its kind" framing deserves an asterisk: Medallion announced CredAlliance in August 2025, describing it as the first national credentialing clearinghouse for payers.

What to do this week: nothing operationally — there is nothing to enroll in yet. What is worth doing is setting expectations internally. If anyone on your team or in your client base has read the coverage and concluded that credentialing is about to become automatic, correct that now rather than in six months. We wrote a fuller breakdown of what the program does and does not change.

2. DEA telemedicine flexibilities: the clock is now under 100 days

Expires December 31, 2026.

Not a September announcement, but September was the month the timeline got uncomfortable. The DEA submitted its final Special Registration rule to OMB's Office of Information and Regulatory Affairs on August 25. The Justice Department forecast puts publication in November. The text is not public.

That leaves a very short window between learning the requirements and having to meet them.

What to do this week: build the provider list. Who on your roster holds a DEA registration, in which states, and whose controlled substance prescribing runs through telemedicine without an in-person evaluation. That list is useful regardless of what the rule says, and it takes longer to assemble than anyone expects.

3. Medicare open enrollment opened October 15 — prepare in advance

October 15 through December 7.

Payer network teams absorb seasonal load during open enrollment, and directory accuracy becomes a compliance priority while members are actively shopping.

What to do this week: check what payer directories currently display for your Medicare Advantage providers — not what you submitted, what is showing. And reset client expectations on any MA application in flight, because turnaround times that held in June will not hold in November.

4. Network and policy changes

Several items moved in September that affect specific rosters:

• Cigna discontinued Medical IFP products in certain markets, affecting provider participation

• Anthem moved enrollment welcome letters to digital delivery, which changes where confirmation of participation arrives

• Fidelis Care confirmed the annual SNP Model of Care training requirement

• UnitedHealthcare issued a D-SNP alignment and network participation update

• Catholic Health updated its IPA credentialing policy

• Spectera Vision Network processed Lincoln Financial and Solstice member transitions

What to do this week: the Anthem change is the easy one to miss. If welcome letters now arrive digitally, confirm they are reaching a monitored address and not an individual's inbox — participation confirmations that nobody reads are participation confirmations that nobody files.

The pattern

Every item above arrived somewhere other than your desk. The CertifyOS announcement ran in trade press. The DEA update sits in a regulatory docket. The payer changes came inside provider bulletins written for clinicians.

That asymmetry is structural: the people who most need this information are rarely on the distribution list for it, and the cost of missing an item is not paid in the month you miss it.

We publish this roundup monthly so there is at least one place where it arrives addressed to you.

Never reconstruct which providers a payer change affects. Start a 30-day free trial: https://credyapp.com/Identity/Account/RegisterDemo.

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