ASCs face increasing delays and denials from payers impacting revenue cycles. Increased scrutiny on device/pharma claims and contract carve-outs prompt ASC contract renegotiations amid Medicare Advantage changes.
UnitedHealth's CEO Stephen Hemsley addresses investor concerns amid rising medical costs, regulatory investigations, and operational challenges affecting the insurer's 2025 earnings forecast and market confidence.
AMA urges HHS to retain the U.S. Preventive Services Task Force members amidst reports of planned dismissals, highlighting the panel's role in guiding evidence-based preventive care covered by insurers. Supreme Court upholds ACA's preventive coverage mandate.
Analysis of the 'Big Beautiful Act' reveals major Medicaid, ACA, and SNAP cuts affecting rural Wisconsin, altering farm subsidies and impacting insurance accessibility and rural healthcare infrastructure.
The AMA calls for retaining USPSTF members to ensure continuity of evidence-based preventive care services covered by insurers under federal law, highlighting the task force's crucial role in U.S. public health.
Colorado's General Assembly schedules a special session to tackle significant impacts of the new federal budget bill on state Medicaid funding, ACA subsidies, and SNAP program changes. The session addresses substantial Medicaid cuts, provider tax caps, and eligibility restrictions affecting Colorado’s healthcare landscape.
ACA health plans face soaring 2026 premiums amid looming expiration of enhanced COVID-era federal subsidies, risking enrollment drops and market volatility.
CMS introduces the WISeR Model pilot program leveraging AI-driven prior authorization to reduce Medicare overuse and fraud in six states from 2026-2031.
Starting in 2025, Medicare prescription drug plans will have a new $2,000 out-of-pocket cap under the Inflation Reduction Act, eliminating the donut hole and lowering costs for beneficiaries. This applies to both Part D and Medicare Advantage plans with drug coverage.
House GOP doctors outline reforms targeting Medicare fraud, PBM-driven drug costs, and graduate medical education funding to address Medicare insolvency and healthcare cost inflation.
