Navigating the Shift to Value-Based Care Amidst Managed Care Growth
Exploring the challenges and strategies for U.S. healthcare finance leaders in the transition to value-based care with the rise of Medicare Advantage and Medicaid Managed Care.
Common Sense Caucus Stands with NYC Retirees in Medicare Coverage Legal Battle
The Common Sense Caucus supports NYC retirees in a legal battle against transitioning to a Medicare Advantage plan, highlighting a pivotal case for municipal commitment to retiree healthcare.
Investigation Requested into Medicare Advantage Plan Business Practices
U.S. lawmakers are requesting a GAO investigation into Medicare Advantage organizations' business strategies, concerning adherence to federal health care spending requirements.
Summary Judgment Recommended in UnitedHealth Medicare Reimbursement Case
A case involving UnitedHealth Group and allegations of improper Medicare reimbursements highlights compliance and regulatory challenges in U.S. health insurance.
President Trump Signs Executive Order Delaying Medicare Drug Price Negotiations
President Trump's executive order delays Medicare drug price negotiations, favoring pharmaceutical companies and potentially increasing drug costs for the public.
President Trump's Executive Order Aims to Lower Drug Prices by Aligning Small Molecule Drug Policy with Biologics
President Trump's latest executive order modifies the Medicare Drug Price Negotiation Program, aligning the treatment of small molecule drugs with biologics and aiming to reduce drug prices.
President Trump's Executive Order to Slash Medicare Drug Prices and Boost Market Transparency
President Trump signed an executive order to lower Medicare drug prices by enhancing drug price negotiations, increasing market transparency, and targeting anti-competitive behaviors.
Congress Calls for GAO Probe into Medicare Advantage Plan Acquisitions
U.S. Representatives urge a probe into Medicare Advantage plans acquiring health businesses, potentially affecting compliance with medical loss ratio standards.
Peterson Center Report Evaluates RPM and RTM in Medicare, Suggests Reforms
Explore the key findings from the Peterson Center on Healthcare's latest report on Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM), suggesting essential reforms for Medicare.
U.S. Insurance Industry Trends: Notable Updates on Prior Authorization
Explore significant updates in the U.S. insurance industry related to prior authorization, including federal and state legislative shifts, and the deployment of AI technology.