The House passed a key appropriations package that would fund the Department of Health and Human Services through Sept. 30, including a step toward reforms for pharmacy benefit managers. The package passed by a 341-88 vote, and it includes elements that would prevent PBMs from tying compensation in Part D to the list price of ...
The House Ways and Means Committee hearing has concluded, bringing a long day of questioning for major health insurance executives to an end. More than nine hours of total questioning across two hearings touched on a slew of factors impacting the affordability of healthcare: the Affordable Care Act, claims denials, prior authorization and consolidation. Paul ...
On January 15, 2026, the California Department of Managed Health Care (DMHC) issued new guidance in All-Plan Letter (APL) 26-002 clarifying the obligation of health care service plans, including Medi-Cal managed care plans, to reimburse providers for COVID-19 testing and immunizations. California Medical Association (CMA)-sponsored Senate Bill 510 (2021) requires health plans and insurers to reimburse providers ...
Pharmacies may have a better chance to win racketeering lawsuits against other insulin supply-chain players than health plans or patients do. U.S. District Judge Brian Martinotti recently issued two rulings that let pharmacies, or “direct purchaser” plaintiffs, move ahead with claims against pharmacy benefit managers that were based on the federal Racketeer Influenced and Corrupt ...
A few small changes to your daily routine could add years to your life. Combined shifts in sleep, exercise and diet may significantly extend lifespan and years spent in good health, according to a new study published in The Lancet. Researchers at the University of Sydney analyzed data from 59,078 adults in the U.K. Biobank. Their sleep ...
Hospital leaders are getting long-awaited clarity from Congress this week as lawmakers unveil a bipartisan healthcare deal tied to a broader government funding package. The 771-page proposal includes major wins for providers, including a multiyear delay of Medicaid DSH cuts, key Medicare payment extensions for rural hospitals and permanent hospital-at-home authority. It also preserves pandemic-era telehealth flexibilities ...