The AHA backs legislation to extend Medicare waivers for hospital-at-home programs, aiming to improve care quality and cost efficiency under new healthcare bills reviewed by Congress.
Rhode Island's health insurance marketplace faces sharp premium increases and enrollment declines after expiration of federal Enhanced Premium Tax Credits. State officials urge congressional action to restore subsidies and maintain affordable coverage.
Two South Florida men indicted for a $34.8 million Medicare fraud involving medically unnecessary durable medical equipment and illegal kickbacks. Highlights compliance and regulatory risks in Medicare billing.
Johns Hopkins Medicine ends contract negotiations with UnitedHealthcare after eight months amid disputes over treatment refusal language in employer-based insurance plans. Highlights payer-provider tensions over network participation and patient access.
Explore recent legislative and CMS efforts to reform prior authorization in U.S. healthcare, focusing on bipartisan bill progress, CMS regulations, and new experimental models to streamline Medicare prior authorization processes.
Bipartisan bill reintroduced to authorize Medicare payments for pharmacists providing basic medical services in underserved and rural areas, enhancing healthcare access for seniors.
The MAHA Commission's new strategic report outlines a multi-agency approach to reduce childhood chronic diseases by enhancing hospital nutrition standards, clinical trial engagement, and advancing price transparency regulations.
CMS invites states to apply for the $50B Rural Health Transformation program aimed at improving rural health outcomes, with a Nov. 5 deadline and specific funding rules.
Medicare's 2025 payment updates introduce advanced primary care and behavioral health codes poised to reshape reimbursement landscapes, addressing primary care financial challenges and influencing specialist payment cuts.
California regulators mandate closure of Meritage Health Plan due to solvency failures, prompting reassignment of 11,000 Medicare Advantage members by Oct. 31, 2025. Insurers must ensure continuity of care amid contract terminations.
