CMS expands enforcement power over shady ACA brokers
A rule finalized Monday makes it easier for regulators to suspend agents and brokers from selling Affordable Care Act plans if they pose a risk to the exchanges.
FTC releases second report slamming pharmacy benefit managers
Agency commissioners voted unanimously on Tuesday to publish the report, which makes similar allegations against the controversial drug middlemen as the agency’s first report released last summer — but relies on more data.
Hospital evaluation of AI predictive tools for bias is inconsistent, study finds
Hospitals with more financial resources and technical expertise were more likely to locally test their models, suggesting a potential digital divide that could impact patient care.
HHS lays out strategic plan for healthcare AI
The agency’s road map, which outlines goals for promoting safe and equitable adoption, comes as the future of AI policy is uncertain under the incoming Trump administration.
Prospect Medical Holdings files for bankruptcy
Prospect is the second large health system with a history of private equity ownership to declare bankruptcy in the past year.
CMS proposes Medicare Advantage payment hike in 2026
The Biden administration’s last MA rule is a boon for insurers, though it remains to be seen how the incoming Trump administration might put its stamp on the regulation before it’s finalized this spring.
Investors ask UnitedHealth for answers about delayed, denied care
On Wednesday, a faith-based group of investors requested UnitedHealth prepare a report looking into how its practices could be leading to “delay or abandonment of medical treatment and serious adverse events for patients.”
After Steward crisis, new Massachusetts law aims to strengthen oversight of hospitals
The law aims to close loopholes that officials say Steward Health Care exploited to keep regulators in the dark about its finances leading up to its bankruptcy.
Walgreens makes progress on turnaround in Q1, though losses grow
Despite a $265 million net loss, investors saw reason for optimism in the quarter, including renegotiated pharmacy contracts and the closure of 70 underperforming stores.
Centene appoints first head of ICHRA products
Longtime WTW executive Alan Silver was named the inaugural president of Ambetter Health Solutions. Silver’s mandate is to accelerate growth in Centene’s ICHRA plans.