Healthcare Fraud Case Highlights Need for Compliance in Insurance
Timothy Klein's healthcare fraud case shows the importance of compliance in insurance. Learn about Medicare scams and prevention strategies.
CMS Launches Voluntary Medicaid MFN Drug Pricing Model; Trump-Era Manufacturer Agreements Expand
CMS unveils the GENERous Medicaid payment model introducing MFN drug pricing, alongside expanded Trump administration drug pricing agreements and key regulatory updates for 2026.
FDA Approves Leucovorin for Autism Amid Investment and Regulatory Clarifications
FDA approves prescription leucovorin for autism treatment; HHS addresses investment and regulatory concerns involving CMS administrator Dr. Mehmet Oz amid public discourse.
Medicare Fraud, Organ Recovery Oversight, and Youth Fitness Legislation Shape U.S. Healthcare Policy
Recent U.S. healthcare updates cover a $34.8M Medicare fraud case, HHS action on organ recovery agency safety, youth fitness legislation, and ACIP's hepatitis B vaccine deliberations.
CMS Pilot Uses AI for Medicare Prior Authorization, Faces Oversight Calls
CMS launches AI-driven pilot to streamline Medicare prior authorization for select services, prompting legislative calls for independent oversight to ensure patient safety and regulatory compliance.
Medicare Launches AI-Driven Pilot to Review Medical Procedure Approvals
Medicare initiates an AI-based pilot program to aid in approving or denying certain medical procedures, raising considerations about healthcare administrative processes and payer-provider dynamics.
Federal Judge Blocks Key Trump-Era ACA Rule Provisions Impacting Coverage
A federal judge blocks major Trump-era ACA provisions that could lead to 1.8 million losing coverage, citing regulatory overreach and increased health costs.
UnitedHealth Faces DOJ Scrutiny Over Medicare Advantage as Industry Faces AI and Market Shifts
UnitedHealth Group responds to DOJ investigations into Medicare Advantage amid broader insurance market changes including AI automation and pharmaceutical supply dynamics.
CMS Proposes Key Medicare Part B Pricing and Reporting Updates for 2026
CMS's 2026 proposed rules for Medicare Part B include major updates to average sales price calculations, Inflation Reduction Act compliance, ASP documentation, and Medicare inflation rebates affecting government pricing.
Illinois Metro-east Hospitals Prepare for Medicaid Funding Cuts and Capacity Shifts
Illinois metro-east hospitals brace for Medicaid funding cuts under new federal law, investing in outpatient care to offset losses. Medicaid work requirements and reduced reimbursements alter hospital financial outlook through 2026 and beyond.