AI-Assisted Prior Authorization Pilot Launches in Washington Medicare
The federal government starts a 6-year AI-assisted prior authorization pilot in Washington and five other states to improve Medicare coverage decisions for costly procedures.
Jack County Hospital District Approves FY 2025-2026 Budget Amid Shifting Medicare Payer Mix
Jack County Hospital District adopts FY 2025-2026 budget with focus on capital needs, rural ambulance grants, and managing shifts between Medicare Advantage and traditional Medicare claims.
Court Rules FOIA Requires Disclosure of Congressional-Agency Communications on ACA Repeal
A court ruling mandates disclosure of federal agency and congressional communications related to the 2017 ACA repeal efforts, reinforcing transparency under FOIA.
Health Insurance Premiums Projected to Rise Up to 55% in Arizona Amid Legislative Actions
Legislative decisions linked to increased health insurance premiums in Arizona, with projections showing up to a 55% rise and potential healthcare coverage losses.
Smart Medigap Plans Expands Medicare Supplement Options in Texas
Smart Medigap Plans broadens Medicare supplement offerings in Texas, enhancing coverage options for Medicare beneficiaries including prescription drug and supplemental insurance.
Impact of MFN Drug Pricing Policy on Medicare Part D Deadline Approaches
The looming deadline for drugmakers to comply with the Most Favored Nation drug pricing policy raises concerns over potential disruptions to Medicare Part D, highlighting regulatory and market risks for U.S. drug pricing and federal entitlement programs.
Value-Based Payment Models Enhance Clinical Outcomes in Medicare Advantage
Study shows value-based payment models with two-sided risk improve clinical quality outcomes for Medicare Advantage beneficiaries compared to fee-for-service.
U.S. Commercial Auto Insurance Sector Posts $10B Underwriting Losses in Two Years
AM Best report reveals $10 billion underwriting losses in U.S. commercial auto insurance over two years, driven by loss severity, social inflation, and reserve issues.
U.S. Life/Annuity Insurance Net Income Rises 39% in H1 2025
The U.S. life/annuity insurance sector saw a 39% net income rise in Q1 2025, driven by premiums, investments, and reserve adjustments per AM Best report.
ACA Subsidies Crossroads: What Expiration Could Mean for Coverage and the Insurance Market
Conservative leaders urge letting ACA COVID-era subsidies expire as government funding negotiations continue, highlighting impacts on insurance premiums and policy stability.