Government
-
Heather Diehl via Getty Images
Doc pay, price transparency on Congress’ healthcare agenda
Lawmakers introduced or advanced a raft of health legislation this week in advance of the midterm elections.
By Emily Olsen • July 17, 2026 -
Andrew Harnik via Getty Images
Senate Republicans kill bid to end Medicare prior authorization pilot
The Senate voted along party lines Thursday to defeat Democrats’ attempt to end WISeR, which some lawmakers argue is delaying care for seniors.
By Emily Olsen • July 17, 2026 -
Explore the Trendline➔
Getty Images
TrendlineSurprise Billing
Federal legislation banning surprise bills has hit a barrage of roadblocks, complicating efforts to protect consumers from unexpected out-of-network charges.
By Healthcare Dive staff -
Getty Images
Judge stays Trump administration policies set to shrink ACA marketplaces
On Thursday, a federal judge pressed pause on the CMS’ expansion of bare-bones catastrophic plans and other changes finalized in a rule this spring, saying they were likely to raise costs and hurt access.
By Rebecca Pifer Parduhn • July 17, 2026 -
Getty Images
340B spending ballooned to $100B in 2025, federal data shows
It's the latest evidence of rising spending in the drug discount program as regulators attempt to tamp down on growth in 340B.
By Sydney Halleman • July 16, 2026 -
Getty Images
Doctor pay to drop in 2027 under proposed Medicare pay rule
Physician groups said the sweeping rule is a double-edged sword, given it includes an unwelcome fee cut but positive changes to Medicare’s value-based and quality payment programs.
By Emily Olsen • July 15, 2026 -
Getty Images
CVS Caremark reaches settlement with FTC over insulin suit
Terms of the deal announced Tuesday are very similar to those the FTC reached with Express Scripts earlier this year, including requiring the PBM to stop preferring higher cost versions of drugs on standard formularies.
By Rebecca Pifer Parduhn • July 14, 2026 -
Getty Images
HHS watchdog says it’s targeting Medicaid, Medicare Advantage fraud
The HHS Office of Inspector General removed over 1,200 people and entities from federal programs between October and March as the Trump administration ratchets up oversight into healthcare fraud.
By Sydney Halleman • July 13, 2026 -
Kayla Bartkowski via Getty Images
‘The system is undeniably broken’: More insurers sue CMS over Medicare Advantage stars
SCAN Health Plan and Alignment Healthcare both filed lawsuits against the CMS last week after regulators refused to recalculate industry-wide MA scores using the same methodology as for Clover Health.
By Rebecca Pifer Parduhn • July 13, 2026 -
Kayla Bartkowski via Getty Images
Soon-to-expire ACO REACH generates more savings for Medicare
The model, which is set to sunset at the end of this year, generated $988 million in savings for Medicare in 2024, according to new CMS data. That’s up from almost $695 million in savings from the year prior.
By Rebecca Pifer Parduhn • July 13, 2026 -
Mario Tama via Getty Images
Bankrupt Omnicare reaches $440M deal with DOJ in fraud case
The settlement could be the end of a long legal saga for Omnicare, which filed for bankruptcy last year after a judge ordered the company to pay nearly $950 million for fraudulently billing government health programs.
By Emily Olsen • July 10, 2026 -
Joe Raedle via Getty Images
ACA premiums set to spike again in 2027
Insurers are proposing a median premium increase of 14% for 2027, according to KFF, suggesting another year of double-digit premium hikes as policy upheaval and rising costs continue to roil the marketplaces.
By Emily Olsen • July 8, 2026 -
Alamy
Centene exits Arkansas Medicaid expansion program, citing funding challenges
ARHOME represents a small portion of Centene’s overall membership and premiums. But the exit shows how insurers are rejigging their businesses in advance of Medicaid work requirements, one analyst said.
By Rebecca Pifer Parduhn • July 8, 2026 -
Getty Images
OpinionHealthcare faces congressional oversight heading into 2026 midterms and beyond
Democrats are planning investigations into major healthcare topics if they win majorities in Congress this November. Healthcare firms should prepare for increased oversight now, write lawyers with Holland & Knight.
By Ashley Joyner Chavous and Christopher Armstrong • July 7, 2026 -
Getty Images
Elevance sues CMS after Medicare Advantage stars recalculation
Regulators recalculated plans’ quality scores last month after losing a lawsuit to Clover Health. But they used a different methodology for Clover than its peers, causing Elevance to lose out on $115 million, the insurer told a court.
By Rebecca Pifer Parduhn • July 2, 2026 -
Getty Images
Fewer health information exchanges say they experience info blocking
Fewer companies appear to be impeding the flow of digital health information, but some could be doing so frequently, the ONC said.
By Emily Olsen • July 2, 2026 -
Kayla Bartkowski via Getty Images
Medicare slashes 340B payments, broadens site-neutral policies in proposed 2027 payment rule
The rule, released Thursday, builds on Trump administration’s priorities, including cutting Medicare reimbursement for drugs in the controversial 340B program and equalizing payment between sites of care.
By Sydney Halleman • July 2, 2026 -
Getty Images
Medicare Advantage bonuses will exceed $13B this year, KFF finds
Medicare is spending more on quality bonuses despite fewer enrollees in eligible plans, the health policy research group said — a concerning trend putting more stress on Medicare’s coffers that could amplify calls for reform.
By Rebecca Pifer Parduhn • July 2, 2026 -
Getty Images
Nearly 4M Medicare beneficiaries could access GLP-1s for weight loss under new program: analysis
Millions of people could meet criteria to receive GLP-1s, which could cost Medicare billions of dollars, according to a report by KFF.
By Emily Olsen • July 1, 2026 -
Getty Images
Court dismisses PBMs’ lawsuit against FTC following insulin settlements
Express Scripts, Caremark and Optum Rx sued the FTC after the agency accused them of driving up the cost of insulin. But the countersuit is being put to bed now that the PBMs are settling with regulators.
By Rebecca Pifer Parduhn • July 1, 2026 -
Alamy
Top FDA gene and cell therapy regulator to step down
Following Vijay Kumar’s exit, acting CBER Director Karim Mikhail will also oversee a review office that has become a battleground for debates on FDA flexibility.
By Jonathan Gardner • June 30, 2026 -
Getty Images
States sue Trump administration over Medicaid work requirements rule
Twenty-six states are seeking to overturn some of the regulation released by the CMS this month that outlined Medicaid work requirements — and asking the court to pause implementation for the time being.
By Sydney Halleman • June 30, 2026 -
Getty Images
ONC rolls out new TEFCA oversight efforts
The health IT regulator awarded a new contract to oversee the framework’s rules for data sharing as the number of health records exchanged through TEFCA balloons.
By Emily Olsen • June 29, 2026 -
Joe Raedle via Getty Images
ACA enrollment declines by nearly 3M
ACA plan enrollment continues to shrink following the lapse of more generous subsidies last year, according to new federal data.
By Emily Olsen • June 29, 2026 -
Rebecca Pifer Parduhn/Healthcare Dive
State Medicaid directors defend program integrity as Dems cry foul in House hearing
The Trump administration says its war on fraud applies to the entire country. But only blue states have had their Medicaid funding threatened or deferred, Democrats argued in a House subcommittee hearing Thursday.
By Rebecca Pifer Parduhn • June 26, 2026 -
Getty Images
Aidoc wins breakthrough nod for AI that reads chest X-rays
Aidoc is working on an artificial intelligence feature that would analyze chest X-rays and generate preliminary reports for more than 100 findings.
By Elise Reuter • June 26, 2026
