Industry Updates
This broad category includes articles concerning health insurance costs, carrier and health plan news, changing benefits technology, and surveys by the Kaiser Family Foundation and others on employee benefits.
In April, the Centers for Medicare & Medicaid Services began enforcing the strongest hospital price transparency rules in the program’s history. The Calendar Year 2026 Outpatient Prospective Payment System final rule eliminates the “estimated allowed amount” placeholder that hospitals used to game disclosure, requires three new data elements based on 12 to 15 months of actual claims ...
When Gavin Newsom ran for California governor in 2018, his support for a state-run single-payer healthcare system was considered a risky move and earned him hefty labor endorsements. Today, leading Democrats in the wide-open race to succeed Newsom have embraced single-payer as a political necessity, an answer to voters fed up with rising premiums and other spiraling healthcare ...
State Obamacare marketplaces are starting to feel tremors from the GOP-controlled Congress’s ending of enhanced subsidies, as millions of Americans are dropping coverage. Experts and state officials say the impact varies from state to state, but enrollment decline is expected to grow this year and beyond, as policies from the One Big Beautiful Bill Act and potential Trump ...
A new proposed rule from the Trump administration aims to make it easier for employers to offer coverage of fertility treatments, as part of larger efforts to expand access to fertility services including in-vitro fertilization. The new rule released Sunday from the Department of Labor would create a new exempted insurance benefit — in the same category as dental and vision benefit coverage— for treating infertility. Exempted benefits don’t have ...
More access to affordable weight-loss medications is coming this summer for adults on Medicare. Starting in July, certain Medicare enrollees can pay $50 a month for specific prescription GLP–1 medications, according to the Centers for Medicare and Medicaid Services. Medicare announced the pilot program for the popular weight loss medications on Wednesday. The Medicare GLP-1 Bridge program will run ...
HHS Secretary Robert F. Kennedy Jr. recently announced an action plan aimed at reducing the overprescribing of psychiatric medications. “Today, we take clear and decisive action to confront our nation’s mental health crisis by addressing the overuse of psychiatric medications — especially among children,” he said last week. “We will support patient autonomy; require informed ...
Employers want greater transparency in their pharmacy benefits, with many viewing a model that eschews rebates as a key way to get there, according to a new survey. The Penta Group surveyed 300 benefits decision-makers, half of whom hailed from companies with 1,000 to 4,999 workers and half from companies with more than 5,000 employees, for Evernorth. ...
Following a series of “most favored nation” (MFN) pricing deals with 17 large pharma companies, the Trump administration released a report Tuesday projecting a potential $529 billion in savings from the policy over the next decade. That $529 billion figure comes from an estimation of prospective MFN, in which biopharma companies pledge to launch all future U.S. ...
The American Medical Association (AMA) rolled out a comprehensive framework to protect physicians from unauthorized artificial intelligence-generated deepfakes. The guide, created by the organization’s Center for Digital Health and AI, aims to modernize physician identity protections while closing legal gaps. The AMA uses the term “augmented intelligence” when referring to AI to emphasize its assistive role in medicine. ...
A new task force will investigate healthcare fraud cases in Nevada, Arizona and part of California, the Justice Department announced Thursday. The West Coast Health Care Fraud Strike Force will combine resources from DOJ’s National Fraud Enforcement Division, and its the Health Care Fraud Section, with U.S. attorney’s offices in Nevada, Arizona and the Northern ...