Supreme Court Considers ACA Preventive Care Coverage Dispute
The Supreme Court reviews a case challenging ACA-required insurance coverage of preventive care services by the U.S. Preventive Services Task Force, impacting millions of Americans.
Prior Authorization Reforms and AI: Transforming U.S. Healthcare Compliance in 2025
Explore the 2024 CMS prior authorization rule and the impact of AI on healthcare administrative processes, improving compliance and patient care timelines.
Supreme Court Case Could Threaten ACA Preventive Coverage
The Supreme Court case Kennedy v. Braidwood Management challenges ACA preventive service mandates, risking coverage for critical screenings and treatments like cancer tests and statins. This ruling has major implications for health insurers and public health.
Reforming Medicare Coverage to Improve Access to Advanced Wound Care Therapies
Explore the impact of Medicare Administrative Contractors on coverage decisions for advanced wound care therapies and the potential of AI-driven reforms to improve patient access and reduce costs.
Alabama Delays AI Regulation in Health Insurance Claims Processing
Alabama postpones legislation regulating AI use in health insurance claims, emphasizing human oversight and collaborative stakeholder discussions for transparency and accountability in insurer decision-making.
Vault Medical Services Settles $8M Covid Testing False Claims Case
Vault Medical Services agrees to pay $8 million to settle false claims related to Covid-19 testing reimbursements under the federal Uninsured Program, highlighting compliance challenges in pandemic healthcare billing.
InsurTech Innovations Reshape U.S. Health Insurance with Dynamic Benefits and Reinsurance
Explore how InsurTech innovations like dynamic benefit plans, reinsurance advancements, and Health Reimbursement Arrangements (ICHRAs) are transforming the U.S. health insurance industry to improve cost management and patient-centered care.
Vitech Launches V3locity Express Software for Supplemental Health Insurance
Vitech introduces V3locity Express, a low-code software platform enabling rapid deployment and enhanced management of supplemental health benefits for group insurers, boosting operational efficiency and cost control.
Court Allows FCA Whistleblower Case Against UnitedHealthcare Over Medicare Advantage Billing
Federal court permits whistleblower's False Claims Act allegations against UnitedHealthcare for improper Medicare Advantage billing to move forward, highlighting legal risks in healthcare billing compliance.
Medicare Enrollment Rules: Individual Plans Don't Delay Part B Without Penalty
Medicare does not recognize individual health plans as qualifying employer coverage for delaying Part B enrollment. Self-employed individuals must enroll timely to avoid penalties.