UnitedHealth Medicare Advantage Faces Lawsuits over AI Claims Denials
UnitedHealth Group faces lawsuits and federal probes over AI-driven claims denials in Medicare Advantage, highlighting regulatory risks and the need for ethical plan advisory.
Medicare Pilot Introduces AI-Driven Prior Authorization in Six States
The new WISeR Medicare pilot uses AI to manage prior authorizations, impacting care access and insurer incentives in six states, with significant implications for rural healthcare.
CMS Launches AI-Powered Prior Authorization Pilot in Traditional Medicare
CMS initiates AI-driven prior authorization pilot in traditional Medicare across six states to reduce wasteful services and control costs, raising provider concerns over care delays.
Congress Debates Healthcare Affordability, CMS Proposes 2027 Medicare Policy Updates
Explore key 2025 updates on healthcare affordability debates in Congress, CMS 2027 Medicare policy proposals, PBM reform legislation, and HHS AI strategy shaping U.S. insurance and Medicare landscapes.
CommonGround 2025 Framework Extends Premium Savings and Advances Healthcare Bills
CommonGround 2025 framework extends premium savings and introduces bipartisan bills targeting Medicaid seniors, military families, and AI modernization in healthcare policy.
U.S. Healthcare Reform Proposals Overlook Employer Role and Data Infrastructure
Healthcare reform proposals repeat Affordable Care Act mistakes by ignoring employers' role and lacking data infrastructure. Expert analysis highlights need for transparent pricing and AI-driven solutions to empower purchasers and control costs.
Curative Raises $150M Series B to Transform U.S. Health Insurance Model
Curative raises $150 million in Series B funding to expand its innovative $0 out-of-pocket health insurance plan, leveraging AI and technology to improve member outcomes and disrupt the traditional BUCA insurance model in the U.S.
Washington's Medicare Adopts AI-Driven Prior Authorization Pilot in 2026
Starting in 2026, Washington state will implement an AI-driven prior authorization pilot for traditional Medicare, raising new compliance and access challenges. Learn about the pilot's impact on Medicare claims processing and healthcare providers.
Banner Health’s Integrated Insurance Model Advances Care Coordination and AI Use
Banner Health's insurance plan integrates health system data and AI technology to improve care coordination, compliance, and member experience in Medicare and Medicaid markets.
Medicare Launches AI-Driven Prior Authorization Pilot to Cut Waste
The Trump administration's Medicare pilot introduces AI-driven prior authorization to reduce waste and control costs, raising regulatory and patient care concerns.