Explore the 2024 CMS prior authorization rule and the impact of AI on healthcare administrative processes, improving compliance and patient care timelines.

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.

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 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 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.

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 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.

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 does not recognize individual health plans as qualifying employer coverage for delaying Part B enrollment. Self-employed individuals must enroll timely to avoid penalties.

CMS's 2026 Final Rule implements the Medicare Drug Price Negotiation Program with the Medicare Transaction Facilitator, affecting Part D drug pricing and pharmacy reimbursement processes.