CMS Launches WISeR Model to Enhance AI-Driven Prior Authorization in Medicare
CMS introduces the WISeR Model in six states to optimize prior authorization using AI, aiming to reduce low-value services and Medicare costs starting 2026.
KBRA Places SILAC Insurance Financial Strength Ratings on Watch Due to Pending Hildene Acquisition
KBRA places SILAC Insurance Company and Sterling Investors Life Insurance Company ratings on Watch Developing ahead of Hildene Capital Management acquisition, pending regulatory approval.
Key M&A Trends Shaping the U.S. Market Outlook for 2026
Explore the top five M&A trends for 2026, including private equity growth, AI integration, and strategic dealmaking insights impacting the U.S. insurance and finance sectors.
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Access timely legal, insurance, and compliance updates with a Law360 subscription. Over 200 daily articles across multiple sectors for industry professionals.
NY Supreme Court Allows Rollout of NYCE PPO Self-Funded Health Plan
New York Supreme Court permits the January launch of NYCE PPO, a self-funded health plan administered by EmblemHealth and UMR, rejecting attempts to block the rollout. The court cited lack of proven harm and legal ambiguities in municipal codes.
Congressional Hearing to Examine Obamacare Subsidy Fraud and Administrative Procedures
Upcoming congressional hearing will review the impact of Obamacare subsidies on healthcare costs and investigate subsidy fraud under the Administrative Procedure Act. Enhanced COVID-19 subsidies set to expire in 2025 are a key focus.
Michigan Moves to Incorporate Virtual Power Plants to Enhance Grid Reliability
Michigan Senate bills propose integrating virtual power plants to improve electrical grid reliability and efficiency by coordinating distributed energy resources and reducing reliance on peaker plants.
Medicare Advantage Plans Exit Vermont, 50,000 Enrollees Seek Alternatives
Medicare Advantage plans are leaving Vermont next year, affecting 50,000 enrollees who must find alternative coverage by year-end due to federal policy changes.
Fort Myers ZIP Code Dispute Highlights Insurance Rate Impacts
Learn how ZIP code designations in Fort Myers, FL affect homeowner and auto insurance rates, prompting regulatory and legislative actions to address rate disparities.
Michigan AG Leads Multi-State Opposition to ACA Abortion Coverage Restrictions
Michigan Attorney General Dana Nessel joins 21 states opposing federal attempts to restrict abortion coverage in ACA insurance plans, emphasizing state sovereignty and access to reproductive health care.