CMS recalculates Medicare Advantage stars after Clover lawsuit loss, but not a freebie for plans

The Latest

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  Lifepoint taps new COO

  Aaron Lewis, who has served as CFO since 2024, takes on the role as the health system looks to expand its footprint and add new services.

  Hospitals

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  Sponsored by Milliman MedInsight

  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

  Payer

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  Fewer insurers participating in ACA marketplaces amid policy turmoil, KFF finds

  The average number of issuers fell from a record high of 9.6 per state in 2025 to just nine this year, according to the health policy research group.

  Payer

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  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.

  Payer

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  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.

  Health IT

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  Express Scripts, PCMA sue to block Tennessee 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.

  Payer

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  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.

  Government

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  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.

  Payer

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  UnitedHealth, FTC reach proposed settlement in insulin case

  The tentative deal comes months after CVS reached a proposed settlement in the lawsuit alleging major PBMs are inflating insulin costs. Cigna has already settled with the FTC.

  Payer

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  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.

  Government

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  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.

  Payer

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  CMS increases oversight of state Medicaid demonstrations

  States will have to provide more rigorous financial analyses for their Medicaid demonstrations beginning in 2027, according to new federal guidance.

  Payer

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  Deep Dive

  UHS deal exposes pitfalls of physician group acquisitions

  Despite major financial struggles, some providers at a physician group in Washington, D.C. say their new — and much larger — parent is not offering the lifeline they want.

  Hospitals

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  Abridge partners with Eli Lilly, Nvidia as AI scribe eyes expansion

  The company is working with Nvidia to build a foundation model for clinical conversations, and it scored a strategic investment from drugmaker Eli Lilly, Abridge announced during a sweeping keynote.

  Health IT

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  CMS creates office dedicated to health technology

  The Office of Health Technology and Products is the latest technology development from the CMS as it doubles down on digital tools.

  Payer

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  Health plans say AI is pushing healthcare costs higher

  Nearly 70% of surveyed health plans said providers’ use of AI documentation and coding tools was a top three trend inflating commercial healthcare costs next year, according to a new report from PwC.

  Payer

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  Humana divests interest in end-of-life provider Gentiva valued at $900M

  The insurer is offloading its interest in the massive end-of-life care provider to an undisclosed group of investors, amid widespread concern about private investors’ activity in healthcare.

  Payer

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  UPMC to lay off 200 employees, cut 300 open positions

  A spokesperson said the layoffs were primarily in non-clinical or member facing roles.

  Hospitals

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  Medicare insolvency date creeps forward thanks to ‘Big Beautiful Bill,’ trustees find

  The trust fund underpinning Medicare’s hospital benefit is set to run out of money one quarter earlier than previously expected as tax cuts in the GOP’s reconciliation legislation shrink Medicare’s revenue.

  Payer

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  House committee takes step toward blocking Medicare AI prior authorization pilot

  It’s another sign of lawmakers’ concern about the pilot, which has been lambasted for delaying care to seniors.

  Payer

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  AMA swears in new president

  Dr. Willie Underwood III said he would focus on uniting physicians across specialties and advancing equity in medicine as president.

  Government

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  Americans mostly blame insurers for rising healthcare costs, survey finds

  AHIP argued the survey, which was commissioned by a pro-hospital advocacy group, is a blatant attempt by hospitals to deflect the blame for ever-higher spending.

  Payer

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  Illinois awards new Medicaid contracts

  The state said it intends to divvy out new contracts, which represent tens of billions of dollars in revenue for each awardee, to six insurers. Winners are mostly incumbents, except for Humana.

  Updated June 10, 2026

  Payer

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  Planned Parenthood clinics close amid funding restrictions: KFF

  Nearly 60 clinics have closed or consolidated with another site since last year, according to the report.

  Government

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  VA deploys Oracle EHR to 4 medical centers in Ohio, Kentucky

  The rollout marks the second wave of deployments in 2026 after the VA largely paused the project for years to fix technical issues and errors.

  Health IT

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  Trump’s $100K fee for H-1B visas struck down

  A federal judge ruled that the fee amounted to an unlawful tax on the visa program for highly skilled workers. Medical groups cheered the decision.

  Hospitals

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