HaysMed CEO Edward Herrman joined a key HHS healthcare policy roundtable discussing rural healthcare challenges, Medicare Advantage concerns, regulatory burdens, and AI opportunities. Insights to inform federal support and reform.

U.S. Rep. Richard Neal discusses the potential impact of federal budget cuts to Medicaid and Medicare on Massachusetts long-term care providers and residents.

Explore how Medicare Part D and C plans cover Jardiance for heart failure and type 2 diabetes, including costs, formularies, and pricing reforms under the Inflation Reduction Act.

Medicare beneficiaries face higher costs as Part D plans shift from fixed co-pays to coinsurance for expensive Tier 3 drugs, raising out-of-pocket expenses significantly.

Caremark is accused of overbilling Medicare Part D by $240-$330 million in a whistleblower lawsuit, raising significant regulatory and compliance concerns for PBMs.

Genexe and Immerge settle $6M case resolving false Medicare claims for unnecessary genetic tests involving kickbacks. Settlement addresses healthcare fraud and whistleblower suits under the False Claims Act.

Detailed analysis of the Trump administration's extensive federal workforce reductions affecting key agencies like EPA, HHS, IRS, and others, with implications for federal compliance and operations.

Medicare Advantage faces scrutiny amid efforts to reduce waste in federal healthcare spending, highlighting challenges in cost efficiency and regulatory oversight.

Mid Coast Medical Center in Trinity, Texas, closes due to financial deficits and reimbursement issues, highlighting rural hospital sustainability challenges. Advocacy for rural emergency hospital designation underway.

UnitedHealth Group reports significant OptumHealth underperformance driven by higher Medicare Advantage utilization and risk adjustment challenges, raising profitability concerns and prompting strategic prioritization of patient engagement.