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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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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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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 -
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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 Rebecca Pifer Parduhn • July 1, 2026 -
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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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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 -
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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 Emily Olsen • 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 Emily Olsen • June 29, 2026 -
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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 Rebecca Pifer Parduhn • 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 Emily Olsen • 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 Rebecca Pifer Parduhn • 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 Emily Olsen • 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 Emily Olsen • 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 Rebecca Pifer Parduhn • 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 Rebecca Pifer Parduhn • 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 Rebecca Pifer Parduhn • 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 Rebecca Pifer Parduhn • 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 Emily Olsen • June 17, 2026
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