Government
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CMS to end subsidies for Medicare drug plan premiums
The CMS said the program, which went into effect last year to stabilize Part D premiums and enrollment, isn’t needed anymore. One researcher said some enrollees could see higher premium increases in 2027 as a result.
By Emily Olsen • July 29, 2026 -
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HHS appeals invalidation of 2025 ACA rule
The Trump administration is fighting to restore controversial provisions that a judge threw out last month, including shorter sign-up windows and heightened eligibility verification.
By Rebecca Pifer Parduhn • July 24, 2026 -
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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 -
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No Surprises disputes continue to swell, CMS finds
Providers and payers initiated 16% more disputes in the second half of 2025 compared with the first half, according to new federal data. But arbiters are closing challenges more quickly and tackling a backlog of disputes.
By Emily Olsen • July 23, 2026 -
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CMS appeals Clover MA stars lawsuit
Last week’s appeal is the latest development in Clover’s legal saga to get the CMS to recalculate its Medicare Advantage star ratings.
By Sydney Halleman • Updated July 24, 2026 -
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Labor Department proposes rule expanding disclosure e-delivery for employer plans
The rule pitched Wednesday would make it easier for group health plans regulated by ERISA to share mandatory notices with their members. A DOL official called the proposal a “big step forward.”
By Rebecca Pifer Parduhn • July 22, 2026 -
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CMS moves to codify limits on Medicaid provider taxes
The new proposed rule is meant to prevent states from guaranteeing providers will be refunded for their taxes, and should save Washington $246 billion over the next decade, regulators said.
By Rebecca Pifer Parduhn • July 22, 2026 -
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Trump administration pauses $1B in Medicaid payments to California, Minnesota
The HHS halted more Medicaid funding to the states on Tuesday, citing concerns about fraud. Critics have slammed the “attack first, ask questions later” strategy of the deferrals, which have only impacted blue states to date.
By Rebecca Pifer Parduhn • July 21, 2026 -
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Doc pay, price transparency on Congress’ healthcare agenda
Lawmakers introduced or advanced a raft of health legislation last week in advance of the midterm elections.
By Emily Olsen • July 17, 2026 -
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Senate Republicans kill bid to end Medicare prior authorization pilot
The Senate voted along party lines to defeat Democrats’ attempt to end WISeR, which some lawmakers argue is delaying care for seniors.
By Emily Olsen • July 17, 2026 -
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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 -
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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 -
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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 -
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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 -
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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 -
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‘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 -
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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 -
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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 -
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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 -
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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 -
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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 -
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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 -
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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 -
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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 -
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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 -
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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
