Government: Page 2

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    Pharmacy groups defend Iowa PBM law amid legal challenge

    The state passed the law in June in a bid to protect independent pharmacies from certain harmful pharmacy benefit manager practices, but it was quickly tied up in litigation.

    By • Oct. 9, 2025
  • CMS Administrator Dr. Mehmet Oz speaks at an Aspen Institute event.
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    Oz speaks out about shutdown, Medicaid cuts, Medicare Advantage audits and more

    Six takeaways from the CMS administrator’s appearance at a D.C. think tank — including why he supports a clean funding bill to reopen the government.

    By • Oct. 7, 2025
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    Supreme Court hears challenge to Colorado’s ban on conversion therapy

    The plaintiffs argue that speech in certain healthcare settings ought to be protected by the First Amendment. Critics say that sets a dangerous precedent, where providers can offer debunked or harmful medical advice with impunity.

    By • Oct. 7, 2025
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    No Surprises dispute resolution remains operational despite shutdown

    However, a prolonged lapse in funding could affect other activities underpinning implementation of the law that holds consumers blameless for unexpected out-of-network bills.

    By • Oct. 6, 2025
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    Medicaid enrollees at risk of disenrollment report multiple chronic conditions: study

    About 41% of beneficiaries who could lose coverage due to federal work requirements signed into law this summer have three or more chronic conditions, according to new JAMA research.

    By • Oct. 6, 2025
  • Torn bills revealing Fraud words. Ideas for Election and voting rights in United States, Money and Taxes
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    Sponsored by ECHO

    Payment fraud in healthcare is getting harder to detect. Here’s how to fight back.

    Fraudsters are raising the stakes. Explore why they’re harder to catch and how to strengthen your defenses across every claim payment.

    By Brian Young • Oct. 6, 2025
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    Humana’s Medicare Advantage star ratings slip for 2026

    Humana is giving investors an early look at stars data after a CMS slip-up led some information to be inadvertantly shared online. The results are in line with expectations but still unsatisfactory, Humana said.

    By • Oct. 2, 2025
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    UnitedHealthcare, Humana, Aetna scale back Medicare Advantage plans for 2026

    The coverage landscape for the privatized Medicare plans will look significantly different next year, giving smaller players a chance to snap up market share but likely creating confusion for seniors.

    By • Updated Oct. 3, 2025
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    FDA seeks feedback on monitoring real-world performance of AI devices

    The agency is looking for ways to detect, assess and mitigate changes to the performance of AI-enabled devices over time.

    By Nick Paul Taylor • Oct. 1, 2025
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    ACA premiums could rise 114% if enhanced subsidies lapse: KFF

    Extending the more generous financial assistance is at the center of a funding fight between Democrats and Republicans on Capitol Hill that shut down the federal government this month.

    By • Oct. 1, 2025
  • The U.S. Capitol stands in the distance as morning traffic moves along North Capitol Street Northwest on October 01, 2025 in Washington, DC. The government shut down early Wednesday after Congress failed to reach a funding deal.
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    Chip Somodevilla / Staff via Getty Images
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    Telehealth flexibilities expire amid government shutdown

    Congress failed to extend the pandemic-era telehealth policies before they lapsed on Oct. 1. Now, providers are scrambling to manage the disruption to virtual care reimbursement and access.

    By • Oct. 1, 2025
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    Trump, Pfizer drug pricing deal short on details, possible impact

    A pact to offer “most favored nation” prices to state Medicaid programs and via direct-to-consumer channels doesn’t affect those on commercial insurance or who won’t pay out of pocket.

    By Jonathan Gardner • Sept. 30, 2025
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    HHS plans to furlough more than 40% of staff if government shuts down

    A shutdown would hit the massive federal healthcare department’s agencies differently. For example, the CMS would lose 47% of its staff, while the CDC and the NIH would lose 64% and 75%, respectively.

    By • Sept. 30, 2025
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    Medical lobbies urge Trump administration to exempt healthcare from H-1B changes

    More than 50 medical groups have signed on to letters calling for healthcare workers to be exempt from new H-1B visa fees, warning the increased costs could cripple vital overseas recruitment.

    By • Sept. 30, 2025
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    Medicare Advantage enrollment projected to fall in 2026: CMS

    Nearly 1 million fewer people could sign up for the privatized Medicare plans next year, according to the CMS, marking the first time in years MA enrollment could decline.

    By • Sept. 29, 2025
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    UPMC patients fight to quash DOJ subpoena of gender-affirming care services

    Patients are asking the health system not to comply with a subpoena seeking information about minors who received gender-affirming care services.

    By • Sept. 29, 2025
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    Hospitals, doctors could lose $32B in revenue next year if ACA subsidies expire: report

    It’s the latest warning about the impact to the healthcare system if the subsidies are allowed to lapse.

    By • Sept. 26, 2025
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    Judge vacates Medicare Advantage audit rule in win for industry

    On Thursday, Texas Judge Reed O’Connor threw out a Biden-era rule that would have recouped billions of dollars in overpayments to MA plans.

    By • Sept. 26, 2025
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    Changes to H-1B visa program threaten to worsen healthcare labor shortages

    Experts worry healthcare providers won’t be able to pay the new $100,000 H-1B application fee. “These are often nonprofit organizations. They don’t have that kind of money lying around,” one lawyer said.

    By • Sept. 25, 2025
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    Physician practice acquisitions on the rise: GAO

    Consolidation with health systems can lead to higher prices, alongside a decrease or no change in care quality, according to a review from the Government Accountability Office.

    By • Sept. 24, 2025
  • Tennessee State Sen. Bo Watson, Tina Joros, Daniel Smith and Sarah Jaromin speaking on a panel at the HIMSS AI Leadership Strategy Summit.
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    States are ramping up AI regulation. How should healthcare respond?

    Industry leaders should engage with state lawmakers on AI bills, given many legislators have limited experience with the technology or in healthcare more broadly, experts said during a HIMSS summit.

    By • Sept. 23, 2025
  • A child receives a standard immunization at Dr. Gary Kramer's pediatric office on September 15, 2025, in Coral Gables, Florida.
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    Deep Dive

    Disparity in vaccine access between states roils patients, providers

    Recent changes to federal guidance on COVID-19 vaccinations have providers worried about what’s to come. “We have opened a door to not using science to guide care,” one physician said.

    By • Sept. 23, 2025
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    States should be full steam ahead on Medicaid work requirements, experts say

    There’s a lot that states want the CMS to weigh in on. But given the tight rollout timeline for the controversial mandates, they shouldn’t delay implementation, experts said during a MACPAC meeting.

    By • Sept. 22, 2025
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    CDC advisers postpone vote to delay some newborns’ hepatitis B shot

    Members of ACIP postponed a planned vote on withholding some infants’ first hepatitis B vaccine dose, adding more confusion to an already muddied meeting.

    By • Sept. 19, 2025
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    Medicare Advantage plans to share provider directories under CMS final rule

    The policy was originally proposed by the Biden administration in November, but comes amid a larger push for more transparency around payers’ provider networks from health officials in the Trump regime.

    By • Sept. 19, 2025