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  • Gavel and stethoscope. medical jurisprudence. legal definition of medical malpractice. attorney. common errors doctors, nurses and hospitals make
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    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 • July 1, 2026
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    Alamy
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    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
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    Trendline

    Surprise 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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    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 • June 30, 2026
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    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 • June 29, 2026
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    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 • June 29, 2026
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    Rebecca Pifer Parduhn/Healthcare Dive
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    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 • June 26, 2026
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    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
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    HHS details takeaways from sweeping AI request for information

    The healthcare sector wants the HHS to coordinate its AI strategy across agencies, provide implementation and governance support, and offer help in evaluating AI tools, leaders said.

    By • June 26, 2026
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    US health spending spikes to $5.7T in 2025, though growth should moderate, CMS finds

    Utilization — not cost growth — continues to accelerate spending, government actuaries said. Rising prescription drug spending, including on GLP-1s, is especially acute.

    By • June 24, 2026
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    Florida launches probe into CVS for alleged anticompetitive pharmacy practices

    The investigation by Florida’s attorney general comes as states look to check pharmacy benefit managers for allegedly driving up drug costs.

    By • June 24, 2026
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    Democrats push for more data on Medicare AI prior authorization pilot

    The letter to the CMS from Democrats is the latest salvo from lawmakers concerned that WISeR is delaying care to Medicare beneficiaries.

    By • June 24, 2026
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    The $50B rural health transformation fund is pushing many hospitals to shrink

    To avoid losing funding, many states are pursuing proven cost-saving strategies like downsizing inpatient care rather than untested approaches, some experts say.

    By Michael Brady • June 24, 2026
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    HHS, responding to China’s rise, moves to fast-track early drug research

    A series of newly planned reforms are designed to entice companies to start early trials in the U.S. rather than overseas.

    By Jonathan Gardner • June 23, 2026
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    Hospitals irate after Eli Lilly follows through on 340B ultimatum

    The drugmaker stopped paying 340B discounts to hospitals that didn’t comply with its new paperwork requirements late last week. Hospitals are urging HRSA to step in.

    By • June 22, 2026
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    PCMA sues to exempt PBMs from Illinois drug law

    It’s the second major lawsuit the pharmacy benefit manager lobby has filed against a state law reforming the industry in recent weeks.

    By • June 18, 2026
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    CMS recalculates Medicare Advantage stars after Clover lawsuit loss, but not a freebie for plans

    Regulators are locking in new 2026 stars for plans if they’re higher under the new methodology. But the recalculation basically results in no change to average star ratings unless you’re Clover, analysts say.

    By • June 18, 2026
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    CBO asks for more No Surprises research

    The No Surprises Act “might not have the effects that CBO anticipated,” the agency wrote in petitioning for more research into the 2020 law’s effect on healthcare prices and other trends. It’s a welcome development for payers.

    By • June 17, 2026
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    Fewer insurers participating in ACA marketplaces amid policy turmoil, KFF finds

    The average number of issuers fell from a record high of 9.6 per state in 2025 to just nine this year, according to the health policy research group.

    By • June 17, 2026
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    The image by Sixflashphoto is licensed under CC BY-SA 4.0
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    OhioHealth settles antitrust suit with the DOJ

    OhioHealth has agreed to void problematic contracts with insurers and not seek such terms moving forward, the Justice Department said. The Ohio nonprofit continues to deny all wrongdoing.

    By • June 17, 2026
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    Express Scripts, PCMA sue to block Tennessee law breaking up PBMs and pharmacies

    Express Scripts and the PBM lobby are following in CVS Caremark’s footsteps in filing complaints challenging the FAIR Rx Act, which was passed earlier this year despite vehement opposition from PBMs.

    By • June 16, 2026
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    Courtesy of Edwards Lifesciences
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    CMS proposes Medicare coverage expansion for TAVR

    The proposed change adds Medicare coverage for beneficiaries with asymptomatic severe aortic valve stenosis who are enrolled in a CMS-approved study.

    By Susan Kelly • June 16, 2026
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    Medicare drug price rule may target under-the-skin cancer immunotherapies

    For 2029, a federal rule proposes closing a "loophole" that protects medicines transitioning from intravenous administration from price protection.

    By Jonathan Gardner • June 15, 2026
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    Judge vacates most of controversial 2025 ACA enrollment, eligibility rule

    Friday’s decision is a victory for insurance advocates. But, given many of the rule’s provisions were codified in the GOP’s “Big Beautiful Bill,” it’s not a panacea for the ACA.

    By • June 15, 2026
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    UnitedHealth, FTC reach proposed settlement in insulin case

    The tentative deal comes months after CVS reached a proposed settlement in the lawsuit alleging major PBMs are inflating insulin costs. Cigna has already settled with the FTC.

    By • June 12, 2026
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    Major Medicare Advantage insurers appear to deny care for profit, federal watchdog finds

    MA insurers commonly deny requests for post-acute care — but none more frequently than UnitedHealth, Humana and CVS, the HHS OIG said. Insurers were not happy about the findings.

    By • June 12, 2026