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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 Rebecca Pifer Parduhn • 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 Rebecca Pifer Parduhn • June 16, 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 -
Courtesy of Edwards Lifesciences
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 Rebecca Pifer Parduhn • 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 Emily Olsen • 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 Rebecca Pifer Parduhn • June 12, 2026 -
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CMS creates office dedicated to health technology
The Office of Health Technology and Products is the latest technology development from the CMS as it doubles down on digital tools.
By Emily Olsen • June 12, 2026 -
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CMS increases oversight of state Medicaid demonstrations
States will have to provide more rigorous financial analyses for their Medicaid demonstrations beginning in 2027, according to new federal guidance.
By Sydney Halleman • June 12, 2026 -
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Medicare insolvency date creeps forward thanks to ‘Big Beautiful Bill,’ trustees find
The trust fund underpinning Medicare’s hospital benefit is set to run out of money one quarter earlier than previously expected as tax cuts in the GOP’s reconciliation legislation shrink Medicare’s revenue.
By Rebecca Pifer Parduhn • June 11, 2026 -
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Planned Parenthood clinics close amid funding restrictions: KFF
Nearly 60 clinics have closed or consolidated with another site since last year, according to the report.
By Emily Olsen • June 10, 2026 -
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House committee takes step toward blocking Medicare AI prior authorization pilot
It’s another sign of lawmakers’ concern about the pilot, which has been lambasted for delaying care to seniors.
By Emily Olsen • June 10, 2026 -
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AMA swears in new president
Dr. Willie Underwood III said he would focus on uniting physicians across specialties and advancing equity in medicine as president.
By Sydney Halleman • Updated Aug. 17, 2026 -
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Illinois awards new Medicaid contracts
The state said it intends to divvy out new contracts, which represent tens of billions of dollars in revenue for each awardee, to six insurers. Winners are mostly incumbents, except for Humana.
By Rebecca Pifer Parduhn • Updated June 10, 2026 -
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VA deploys Oracle EHR to 4 medical centers in Ohio, Kentucky
The rollout marks the second wave of deployments in 2026 after the VA largely paused the project for years to fix technical issues and errors.
By Emily Olsen • June 9, 2026 -
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Trump’s $100K fee for H-1B visas struck down
A federal judge ruled that the fee amounted to an unlawful tax on the visa program for highly skilled workers. Medical groups cheered the decision.
By Natalie Schwartz • June 8, 2026 -
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Cities sue to block ACA rule for increasing uninsured rate
City leaders said the regulation risks undermining the Affordable Care Act exchanges and adding new costs for local governments. Now, they’re suing to overturn the rule.
By Sydney Halleman • June 8, 2026 -
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Over half of Medicaid enrollees say they’re unaware of upcoming work requirements
Many enrollees don’t know they’ll need to report work, education or volunteer hours starting in less than six months in order to stay covered, according to a recent survey from the Health Management Academy.
By Emily Olsen • June 8, 2026 -
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Ascension closes AmSurg deal following FTC scrutiny
Regulators cleared the nonprofit’s $3.9 billion AmSurg acquisition — but with conditions.
By Sydney Halleman • June 5, 2026 -
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FTC requires Ascension divestitures in $3.9B AmSurg deal
Ascension needs to sell seven surgery centers if it wants the deal to close, regulators said. Ascension, which is pursuing the AmSurg acquisition as part of a larger financial turnaround, said it was pleased with the compromise.
By Rebecca Pifer Parduhn • June 2, 2026 -
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Eli Lilly issues data sharing ultimatum to 340B hospitals
Select hospitals have refused to share data to prove they’re not double-dipping drug discounts, Lilly said. Hospitals, which have until Monday to comply, are urging the government to intervene.
By Rebecca Pifer Parduhn • June 2, 2026 -
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CMS releases Medicaid work requirements guidance for states
The highly anticipated interim final rule weighs in on key issues for states hustling to operationalize work requirements before the 2027 deadline. But there’s still some gray area — and lots of critics.
By Rebecca Pifer Parduhn • Updated June 2, 2026 -
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Massachusetts sues UnitedHealthcare for alleged Medicaid fraud
The state claims UnitedHealthcare inflated the sickness of seniors enrolled in MassHealth managed care plans to reap at least $100 million in improper payments.
By Emily Olsen • June 1, 2026 -
Permission granted by Elevance Health
Elevance again avoids Medicare Advantage sanctions, but threat remains
The CMS pushed back sanctions until July 1 after Elevance made progress on fixing faulty data submissions for its privatized Medicare plans. But the company still has more to do, regulators said.
By Rebecca Pifer Parduhn • June 1, 2026 -
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‘A missed opportunity’: Payers lash out against surprise billing final rule
A highly anticipated rule finalized Thursday meaningfully improves how insurers and providers settle disputes over out-of-network bills. But payers say it doesn’t go far enough to curb alleged provider abuse.
By Rebecca Pifer Parduhn • May 29, 2026
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