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 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.
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 Group responds to DOJ investigations into Medicare Advantage amid broader insurance market changes including AI automation and pharmaceutical supply dynamics.
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 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.
CMS initiates survey collecting hospital outpatient drug acquisition costs to align Medicare payments with actual costs under the 2026 OPPS update, following a federal Executive Order to reduce prescription drug expenses.
Explore how medical debt financing companies support rural hospitals facing financial challenges amid Medicaid and ACA funding cuts, impacting uninsured patients and hospital revenue cycles.
Hospices confront rising operational costs, increased audits, and potential Medicare Advantage coverage changes in 2025, impacting hospice care delivery and financial sustainability.
UnitedHealth replaced CEO Andrew Witty after financial challenges related to Medicare coverage led to profit declines and withdrawn guidance, highlighting regulatory and cost pressures in the insurance market.
