CMS Launches WISeR Model to Cut Overuse in Medicare with AI-Driven Prior Authorization
CMS introduces the WISeR Model pilot program leveraging AI-driven prior authorization to reduce Medicare overuse and fraud in six states from 2026-2031.
CMS Narrows Medicare Custody Definition to Expand Coverage Access in 2025
CMS finalized a 2024 rule narrowing Medicare custody to physical confinement, expanding Medicare coverage for community-supervised individuals starting 2025.
Alaska Enacts Senate Bill 133 to Streamline Health Insurance Authorization Process
Alaska's new Senate Bill 133 mandates faster health insurance authorization decisions and increased transparency, enhancing patient access and insurer accountability effective 2027.
$1 Trillion Medicaid and ACA Cuts Threaten New York Health Coverage
Explore how $1 trillion in federal Medicaid and ACA funding cuts will impact New York's health coverage, rural hospitals, and SNAP nutrition support, with significant economic repercussions.
Trump Administration Advances Medicare Drug Price Negotiation Amid Industry Concerns
The Trump administration proceeds with the third cycle of Medicare drug price negotiations, addressing Part B drug inclusion and sparking pharmaceutical industry concerns about pricing and implementation.
Senate Passes Tax Bill Cutting $1 Trillion From Health Care Spending
Senate Republicans approved a tax bill reducing health care spending by $1 trillion over 10 years, affecting 12 million Americans' insurance coverage and state Medicaid programs.
Republican Bill Targets Fraud and Abuse in Obamacare to Save $106B
Explore how the One Big Beautiful Bill Act aims to enhance Obamacare's integrity by tightening enrollment periods and subsidy verifications to reduce fraud and save $106 billion in federal funds.
U.S. Tariffs on Medical Imports Prompt Health Plan Premium Increases for 2025
Tariffs on medical imports have led U.S. health plans to plan premium increases for 2025 due to rising drug and device costs, impacting payer pricing strategies and market outlooks.
Congressional Medicaid Cuts and Work Requirements Could Threaten Coverage in Missouri and Kansas
Congressional proposals to cut Medicaid funding and impose work requirements could lead to significant coverage losses in Missouri and Kansas, impacting rural healthcare and SNAP benefits.
Three Blue States Trim Undocumented Immigrant Health Coverage Amid Budget Pressures
California, Illinois, and Minnesota scale back state-funded healthcare coverage for undocumented immigrants due to budget constraints, reflecting broader Medicaid funding challenges and immigration policy debates.