Recent legislative changes to Medicare’s drug price negotiation program expand orphan drug exclusions, delaying price negotiation for expensive specialty drugs and increasing costs for Medicare beneficiaries.
Medicare Part D sees near-universal prior authorization and rising out-of-pocket costs for GLP-1 drugs in 2025, reflecting insurer adjustments to new cost and regulatory pressures.
The Trump administration's WISeR pilot program introduces AI-driven prior authorization in Medicare to reduce waste and fraud, raising concerns over patient care and regulatory oversight.
Explore how AI-powered predictive analytics improve diabetes management and reduce Medicare costs through personalized patient adherence interventions.
Medicare telehealth waivers enabling expanded coverage during COVID-19 expire in 2025. Providers must prepare for significant Medicare and regulatory changes affecting telehealth reimbursement and compliance.
The Trump administration's $100,000 H-1B visa fee poses challenges for the healthcare workforce, especially in rural areas, amid hospital closures, regulatory penalties, and healthcare market shifts.
Understand critical Medicare enrollment periods, penalties, and coverage options to inform insurance professionals and advisors guiding clients through retirement healthcare transitions.
The Patients Over Profits Act aims to prohibit ownership of both health plans and providers to curb vertical integration in Medicare-related markets, impacting major payviders like UnitedHealth Group and influencing U.S. healthcare market competition and regulatory enforcement.
Louisiana's Office of Group Benefits is transitioning pharmacy benefit management services from CVS Caremark to Liviniti and SilverScript for 2026 amid legal scrutiny and demand for PBM transparency.
Key Medicare 2025 updates include potential Medigap cost increases and the importance of reviewing the Annual Notice of Change before the December 7 enrollment deadline. Learn about Medicare Advantage plans and state ACA compliance.
