CMS proposes Medicare coverage expansion for TAVR
The proposed change adds Medicare coverage for beneficiaries with asymptomatic severe aortic valve stenosis who are enrolled in a CMS-approved study.
IRhythm discloses data stolen from third-party applications in cyberattack
The cardiac monitoring company said that a threat actor has demanded payment in exchange for not publicly releasing the stolen data.
Centene offers employee buyouts amid membership losses
Most of Centene’s 61,000 employees will be eligible to apply for voluntary separation. But the program doesn’t amount to a complete overhaul of the company, a spokesperson said.
Express Scripts, PCMA sue to block Tennesee law breaking up PBMs and pharmacies
Express Scripts and the PBM lobby are following in CVS Caremark’s footsteps in filing complaints challenging the FAIR Rx Act, which was passed earlier this year despite vehement opposition from PBMs.
Judge vacates most of controversial 2025 ACA enrollment, eligibility rule
Friday’s decision is a victory for insurance advocates. But, given many of the rule’s provisions were codified in the GOP’s “Big Beautiful Bill,” it’s not a panacea for the ACA.
Medicare drug price rule may target under-the-skin cancer immunotherapies
For 2029, a federal rule proposes closing a “loophole” that protects medicines transitioning from intravenous administration from price protection.
How healthcare AI is closing the revenue gap
Discover how healthcare organizations are moving from early experimentation to broader AI adoption, connecting clinical improvements to financial impact.
Data analytics for payers: Improving maternal health outcomes while reducing total cost of care
How health plans can use analytics to improve maternal care and reduce avoidable utilization
UnitedHealth, FTC reach proposed settlement in insulin case
The tentative deal comes months after CVS Health reached a proposed settlement in the lawsuit alleging major pharmacy benefit managers are inflating insulin costs.
Major Medicare Advantage insurers appear to deny care for profit, federal watchdog finds
MA insurers commonly deny requests for post-acute care — but none more frequently than UnitedHealth, Humana and CVS, the HHS OIG said. Insurers were not happy about the findings.