CMS's 2027 Proposed Rule introduces major Medicare Advantage and Part D program reforms including Star Ratings revisions, risk adjustment data access expansion, marketing rules relaxation, and new special enrollment periods for provider terminations.

CMS is piloting an AI-driven prior authorization program in traditional Medicare across six states to reduce wasteful services and healthcare costs, amidst concerns over delays and administrative burdens.

CMS is launching the WISeR Model, an AI-powered prior authorization pilot in traditional Medicare aimed at reducing wasteful services. The program raises concerns about care delays and administrative burdens among healthcare providers in six states.

The AHA's Q2 2025 Health Care Plan Accountability Update details key regulatory and legislative changes affecting Medicare Advantage and private health insurer compliance, essential for insurance professionals.

The Supreme Court evaluates the constitutionality of the Affordable Care Act's preventive services mandate by assessing the U.S. Preventive Services Task Force's structure, with potential widespread impact on no-cost preventive coverage in American health insurance.