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Federal watchdog accuses Humana, UnitedHealthcare Medicare Advantage plans of upcoding
Newly released HHS OIG audits of HumanaChoice and UnitedHealthcare of Wisconsin found both plans frequently exaggerated the health needs of their members, generating almost $180 million in overpayments over two years.
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Sponsored by Elisity, IncWhy hospital network segmentation projects stall and what that means for patient safety
Most health systems start network segmentation. Far fewer finish. Why that gap affects care.
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Mental health gap widens between employed and independent physicians: survey
Employed doctors report worse well-being than independent practitioners, with workload and administrative burden driving distress.
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More health plans score 5 stars on NCQA ratings, but for-profits underperform
Eighteen plans scored a perfect 5 stars in the standards organization’s ratings for 2026, up from 11. There are no for-profits among them.
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Courtesy of Express Scripts
Express Scripts targeted by Arkansas pharmacies in first-of-its-kind lawsuit
Arkansas passed a law last year giving pharmacies the authority to sue PBMs for underpayments. Twelve independent pharmacies are now the first to take advantage of the new enforcement mechanism.
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70% of Gen Z healthcare workers say they’re going to quit within the next year
Employers need to start offering more perks like education benefits in order to retain young workers, according to a survey from the Harris Poll. That’s notable for employers who need to stave off workforce shortages, one expert said.
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CMS to add more chronic conditions to ACCESS model in 2027
The Trump administration is expanding Medicare’s new technology-based payment experiment to cover more chronic conditions, including COPD, substance use disorder and tobacco cessation.
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OIG urges crackdown on equipment suppliers in Medicare Advantage
The agency says the CMS and MA organizations aren’t doing enough to screen durable medical equipment providers, especially out-of-network companies that aren’t enrolled in Medicare.
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HHS adds new IDR entity as surprise billing disputes surge
Physio Solutions, which does business as Medlitix, is the 17th company certified to settle out-of-network payment disputes under the No Surprises Act as arbiters face increasing scrutiny from researchers and lawmakers.
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2.3M young adults could lose Medicaid due to Big Beautiful Bill: study
Actual disenrollment will depend heavily on how easy states make it for young adults, who move frequently and participate in hard-to-track gig work, to prove they should stay enrolled, the Urban Institute found.
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Johnson & Johnson requires providers to share claims data to get 340B discounts
The drugmaker is the latest to impose a reporting requirement on 340B providers, saying stricter guardrails are needed to prevent duplicative discounts.
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Oracle targets nurses with latest AI tool
U.S. nurses can use Oracle’s clinical artificial intelligence agent to generate nursing summaries and search for and navigate patient charts via voice commands.
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Conifer to lay off over 1,000 workers
The layoffs come months after CommonSpirit announced it was ending its service contract early and exiting its stake in the Tenet-owned revenue cycle company.
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More than half of hospitals still not fully compliant with price transparency rules: report
A record number of hospitals are fully sharing data on the cost of their services, thanks to the CMS stepping up enforcement. But there’s still a ways to go, according to PatientRightsAdvocate.org.
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Courtesy of Boston Scientific
Boston Scientific fully restores operations after cyberattack
CEO Mike Mahoney gave more details at an investor conference, saying the company likely lost orders while its plants and distribution centers were shut down.
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ARPA-H to invest $62M to build agentic AI agent for heart care
The funding could create a regulatory approval pathway for future applications of clinical-grade artificial intelligence.
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Health spending tied to rise in premiums, new study finds
The study published in JAMA counters concerns that insurers are raising premiums to pad profits.
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Half of Medicare Advantage stars thresholds harder to reach in 2027
The CMS has released draft star ratings, including the thresholds for reaching those ratings, to plans. The grading sheet got stricter, which doesn’t bode well for insurers, one MA expert said.
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Veterans Affairs taps Amwell for telehealth revamp
It's another prong in the agency's digital health modernization project, which has faced setbacks and delays.
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Health Catalyst appoints new CEO
The data analytics company has cycled through three CEOs in eight months. Health Catalyst is betting its newest chief can navigate an AI pivot and revenue headwinds.
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Top Democrat investigates No Surprises arbiters
Rep. Frank Pallone sent oversight letters to six arbiters requesting information on how they decide awards, how they’re paid and more. His office is also in talks with other arbiters, but they’ve been more responsive, a staffer said.
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Half of U.S. hospitals lack maternity wards as Medicaid cuts loom: report
Nearly half of U.S. hospitals are now without obstetric services, according to a new report, and closures could worsen as Medicaid cuts threaten hospital finances.
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Courtesy of UnitedHealth Group
UnitedHealthcare expects to be ‘very competitive’ in Medicare Advantage next year, CFO says
The insurer is still working on strategies to ensure its MA markets remain as profitable as possible, but it’s confident in its posture heading into 2027 open enrollment, Wayne DeVeydt said Wednesday.
Updated Sept. 10, 2026 -
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Trinity Health to lay off 557 IT workers
It’s the second wave of layoffs at the nonprofit this year. Trinity said financial pressures and increasingly complex technology requirements were driving it to outsource some tech roles.
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Q&AFinance is ‘leaning in’ to manage healthcare costs, WTW exec says
CFOs are increasingly partnering with human resource executives to help trim rising healthcare costs, WTW’s Tim Stawicki says.
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Mass General Brigham health plan drops MA coverage for Dana-Farber patients
The contract lapse comes as the health system and cancer institute wind down a decades-old partnership.
