The DOJ is broadening its investigation of UnitedHealth Group, examining prescription management practices at Optum Rx and physician reimbursement methods amid concerns beyond Medicare fraud.
A federal judge blocks major provisions of CMS's new ACA Marketplace rule, pausing stricter eligibility checks and subsidy limits that affect coverage for 1.8 million people.
AM Best revises US health insurance outlook to negative due to rising medical utilization, increased specialty drug use, and regulatory challenges impacting Medicare Advantage and Medicaid programs. Premiums projected to rise up to 60% by 2025.
House Resolution 1 enacts major Medicare and Medicaid reforms, affecting millions of Americans including immigrants and low-income families, with implications for insurance markets and healthcare providers.
CMS will not approve new Medicaid 1115 waivers for workforce initiatives, shifting federal support away from addressing provider shortages via these programs. This change affects state capacity to invest in Medicaid workforce development.
CMS introduces a new verification process for Medicaid and CHIP to ensure enrollee eligibility, safeguard taxpayer funds, and enhance program integrity with state-level review and enforcement.
Catalyst Solutions completed a rapid 60-day implementation of Professional Health Partners services across Arizona, Oregon, Nevada, and California, enhancing Medicare population health management with scalable, hybrid onshore/offshore support.
An in-depth analysis of 2024 U.S. healthcare policy updates affecting Medicaid, Medicare payments, telehealth, and administrative reforms impacting medical groups and physicians.
A North Carolina federal court ruling restricts federal jurisdiction in health care reimbursement disputes involving 340B program contracts, emphasizing state law's primacy in provider-payer agreement claims.
Wellth secures $36 million Series C funding to enhance its AI-driven platform that improves medication adherence and preventive care in Medicare Advantage and Medicaid populations.
