President Trump signs an executive order setting a 30-day deadline for drugmakers to lower prescription drug prices in the U.S. or face new federal limits tied to international prices.
Democrats call on GOP leaders to stop Medicaid cuts and focus on Medicare Advantage upcoding to reduce $50 billion in federal overpayments and protect healthcare coverage.
The Trump administration plans to reintroduce a 'most favored nation' drug pricing model for Medicare, aiming to align U.S. drug prices with lower international rates. This strategy faces industry opposition but could complement existing Medicare drug price negotiations to reduce costs.
Colorado's Journey of Care introduces a dedicated value-based palliative care model targeting Medicare Advantage and special needs plans with interdisciplinary services and telehealth support.
Rep. Spartz introduces the SMART Health Care Act to reduce Medicare and Medicaid waste, address hospital overbilling, enhance rural healthcare access, and reform the 340B drug program.
Health insurance coverage for prescription medications declined with increased restrictions in 2025, impacted by pharmacy benefit manager policies and limited regulations.
CMS's GUIDE Model is reshaping Medicare dementia care with home-based solutions, virtual nursing, and new respite care reimbursements to improve patient outcomes and reduce costs.
Explore Humana's detailed prior authorization requirements for medical services and medications, including timelines, appeal rights, and Medicare member guidance for coverage approvals.
New Medicare Part D rules in 2025 cap oral cancer drug costs at $2,000 annually and introduce a voluntary monthly payment plan to improve affordability for patients.
Updates on U.S. healthcare budget reconciliation delays, Medicaid policy debates, Medicare Advantage lawsuits, HHS budget for FY 2026, and new NIH research initiatives shaping insurance and healthcare regulation.
