Judge tosses another No Surprises lawsuit against HaloMD
A federal judge dismissed another lawsuit brought by an Elevance health plan alleging the billings intermediary was gaming the arbitration process set up by the No Surprises Act.
Doctor pay to drop in 2027 under proposed Medicare pay rule
Physician groups said the sweeping rule is a double-edged sword, given it includes an unwelcome fee cut but positive changes to Medicare’s value-based and quality payment programs.
Providence names new chief supply chain officer
Amanda Chawla comes to the Washington-based nonprofit giant from Stanford Medicine. Providence is hoping her appointment will bolster its supply chain capabilities during a time of elevated spend.
CVS Caremark reaches settlement with FTC over insulin suit
Terms of the deal announced Tuesday are very similar to those the FTC reached with Express Scripts earlier this year, including requiring the PBM to stop preferring higher cost versions of drugs on standard formularies.
‘The system is undeniably broken’: More insurers sue CMS over Medicare Advantage stars
SCAN Health Plan and Alignment Healthcare both filed lawsuits against the CMS last week after regulators refused to recalculate industry-wide MA scores using the same methodology as for Clover Health.
Hospital M&A sustains momentum in Q2: report
Hospitals and health systems recorded 18 transactions in the second quarter after a lull in dealmaking early last year as providers look to partner up to bolster their finances.
HCA cuts 2026 earnings forecast on insurance coverage losses
Payer mix changes, mostly from people dropping out of Affordable Care Act plans, caused HCA to lose $400 million in the second quarter — much more than the company (or its investors) had expected.
HHS watchdog says it’s targeting Medicaid, Medicare Advantage fraud
The HHS Office of Inspector General said it had kicked over 1,200 people and entities off federal programs between October and March as the Trump administration ratchets up oversight into what it says is rampant fraud in healthcare.
Soon-to-expire ACO REACH generates more savings for Medicare
The model, which is set to sunset at the end of this year, generated $988 million in savings for Medicare in 2024, according to new CMS data. That’s up from almost $695 million in savings from the year prior.
The automated practice: A survival strategy for independent healthcare
Why automation is becoming essential for independent practice survival.