The Latest

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  Early ACA enrollment holds steady despite subsidy turmoil

  Some 5.8 million people have signed up for 2026 ACA plans so far, up about 7% year over year. Still, enrollment tends to shift over signup periods, so it’s too early to conclude that the Obamacare exchanges won’t shrink next year.

  Payer

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  Sponsored by Documo

  Stuck in the fax lane: How legacy workflows are straining healthcare operations

  Fax ensures compliance, but manual workflows slow healthcare teams. Documo’s 2025 survey shows how Intelligent Document Processing and automation close the gap.

  Health IT

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  Crapo, Cassidy propose enhanced ACA subsidy alternative

  The legislation, which is scheduled for a vote Thursday, would send funds directly to health savings accounts paired with bronze or catastrophic plans offered on the Affordable Care Act exchanges.

  Payer

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  GE HealthCare, Mayo Clinic expand partnership around radiology research

  Ben Newton, GE HealthCare’s global head of oncology, said the partnership will shift radiation therapy from a “one-size-fits-all” approach to a personalized method.

  Hospitals

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  Change cyberattack relief funding overpaid many hospitals: study

  But more than 300 hospitals didn’t participate in the CMS’ relief program, even though they faced financial disruption — and were more likely to be small and rural facilities, according to Health Affairs research.

  Hospitals

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  HCA taps new VP of community engagement

  Virginia Tenpenny will oversee the hospital operator’s community engagement initiatives, including its social and charitable investments, outreach and strategic partnerships.

  Hospitals

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  1 in 4 ACA enrollees could go uninsured if subsidies lapse: KFF

  Nearly 60% of survey respondents said they wouldn’t be able to afford a $300 annual increase in healthcare costs without significantly disrupting their finances.

  Payer

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  Deep Dive

  What medtech firms can learn from Whoop’s warning letter

  An FDA warning letter about the wearable company’s blood pressure feature raises questions about the blurring lines between medtech and wellness.

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  Aetna updates on prior authorization reform

  The CVS-owned payer is working to bundle multiple prior authorizations for certain conditions into one single review.

  Payer

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  HHS outlines strategy to expand AI adoption

  Although the strategy is internally focused to start, the agency said it will collaborate with the private sector and identify “priority” conditions and health issues that could be addressed with AI tools. 

  Health IT

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  Senators agree they need to act on expiring ACA subsidies. But they can’t nail down how.

  Hidden in Republicans’ ACA bashing during a health committee hearing last week were some signs that a clean extension of more generous subsidies isn’t completely off the table — though one still doesn’t look likely.

  Payer

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  ‘Discredited’ CDC panel weakens endorsement for newborns’ hepatitis B shot

  After initially delaying a vote, ACIP backed a softer stance that dissenting members warned would cause harm to children in the future.

  Updated Dec. 5, 2025

  Government

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  PitchBook: AI tuck-in deals to drive M&A acceleration in 2026

  Buyers will focus on “tuck-ins that add AI or data-driven capabilities or can meaningfully improve scale against emerging competitors,” analysts said.

  Health IT

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  Covert watchdog testing finds ACA vulnerable to subsidy fraud

  The Government Accountability Office successfully enrolled 18 out of 20 fake applicants in subsidized ACA plans. Republicans jumped on the report as ammunition in the debate over expanded subsidies.

  Payer

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  CHS sells lab assets to Labcorp for $194M

  The deal, first announced in July, includes outreach laboratory services in 13 states. CHS will continue to operate inpatient and emergency department labs.

  Hospitals

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  House passes bill extending hospital at home waivers for five years

  The bill would waive certain requirements to enable hospitals to provide acute inpatient care in patients’ homes through 2030. It now heads to the Senate.

  Hospitals

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  Trump administration repeals Biden-era nursing home staffing mandate

  HHS repealed the rule on Tuesday, which would have required nursing homes to increase staffing, saying the regulations would have disproportionately harmed rural communities.

  Government

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  Hospitals sue to block HHS 340B rebate pilot

  The American Hospital Association, a Maine hospital group and four nonprofit systems are seeking a temporary restraining order against HHS’ controversial test of a new discount structure in the decades-old program.

  Hospitals

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  CVS agrees to pay $38M to settle insulin fraud claims

  For a decade, CVS knew it was skirting rules meant to limit overprescribing but did nothing to stop, according to the Department of Justice.

  Payer

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  Richard Pazdur, FDA drug czar, to retire from agency

  Weeks after being named head of CDER, Pazdur has submitted paperwork to step down at the end of the month, exacerbating what’s already been a turbulent year at the FDA.

  Government

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  Family physicians are departing rural areas: report

  Between 2017 and 2023, the share of family physicians working in rural areas dropped 11%, according to a study published in the Annals of Family Medicine.

  Medical Groups

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  Humana appeals Medicare Advantage star ratings loss to 5th Circuit

  The insurer continues to try to prove that regulators acted arbitrarily in downgrading its quality scores for 2025, despite numerous setbacks in the courts to date.

  Payer

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  Lawmakers propose Medicare reimbursement pathway for AI devices

  The legislation is intended to ensure AI-enabled devices receive an accurate CMS payment code.

  Government

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  CMS proposes overhauling Medicare Advantage star ratings

  The agency suggested cutting a dozen quality measures where health plan performance is high and beneficiaries can’t easily distinguish between offerings.

  Payer

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  OIG report finds Medicare overpaying for CGMs and supplies

  The CMS could use its competitive bidding program to address price concerns after payments for the continuous glucose monitors swelled over five years, the government watchdog said.

  Government

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  CMS sets 2027 Medicare prices for Wegovy, Trelegy and 13 other drugs

  The second round of negotiations cuts spending an aggregate 44% over 2024 list prices as the federal government extends restraints over more medicines.

  Payer

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