CMS Launches WISeR Model to Cut Overuse in Medicare with AI-Driven Prior Authorization
CMS introduces the WISeR Model pilot program leveraging AI-driven prior authorization to reduce Medicare overuse and fraud in six states from 2026-2031.
2025 Medicare Drug Plan Caps Lower Out-of-Pocket Costs Under Inflation Reduction Act
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.
Congressional Doctors Advocate Medicare, PBM Reforms to Curb Fraud and Costs
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.
Iowa Medicaid and Medicare Savings Programs Aid Low-Income Beneficiaries
Explore how Iowa's Medicaid and Medicare Savings Programs provide critical financial assistance for low-income Medicare beneficiaries, covering premiums, deductibles, and prescription drug costs.
Comprehensive Tax Provisions in the "One Big Beautiful Bill" Impact U.S. Tax Laws
Explore key tax law changes in the One Big Beautiful Bill (BBB) affecting individual and corporate taxes, deductions, and credits in the U.S.
Venus Williams' Returns To Tennis For The Health Insurance Coverage
Venus Williams' return to tennis draws attention to the high costs of COBRA health insurance and broader U.S. challenges with medical debt and health care affordability.
Trump Health Care Policy Cuts Expected to Increase Medical Debt
The Trump administration's Medicaid cuts and health policy changes are projected to increase medical debt and reduce insurance coverage protections for Americans, impacting affordability and credit scores.
UnitedHealth Group Faces DOJ Probes Over Medicare Billing and Coding Practices
UnitedHealth Group confirms DOJ investigations into Medicare billing and diagnosis code practices, impacting regulatory compliance and Medicare program integrity.
UnitedHealth Cooperates with Federal Investigations of Medicare Advantage Practices
UnitedHealth Group is cooperating with federal investigations into its Medicare Advantage billing practices amid scrutiny over diagnosis-based payments. The insurer faces civil and criminal probes amid increased healthcare utilization and financial pressure.
UnitedHealth Faces Federal Investigations Over Medicare Advantage Billing Practices
UnitedHealth Group is under federal criminal and civil investigation for Medicare Advantage billing practices amid financial pressures and leadership changes. The company cooperates fully and maintains confidence in compliance.