CMS wants seniors to use AI for care navigation

The agency plans to introduce AI agents to help Medicare beneficiaries find doctors and health plans, a challenge given many enrollees don’t yet trust the tools, CMS Administrator Dr. Mehmet Oz said during the HIMSS conference.

By Emily Olsen • March 13, 2026

Genetic tests come under scrutiny in Trump administration’s fraud crackdown

As the CMS calls for public feedback on how to stop lab test fraud, experts say a tailored regulatory strategy will be key to avoid stifling innovation.

By Susan Kelly • March 12, 2026

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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

FDA to unify agency’s ‘fragmented’ safety surveillance system

Combining the disparate databases used to detect potential issues with drugs, vaccines and other products into a single dashboard will enhance their utility and cut costs, the agency said.

By Kristin Jensen • March 12, 2026

Developers stand to lose IT certification if found information blocking

Customers of IT developers who lose their certification would also forfeit some financial incentives, ASTP/ONC head Dr. Thomas Keane said at the HIMSS conference.

By Emily Olsen • March 12, 2026

Safety-net providers tackle AI adoption as Medicaid cuts loom

Artificial intelligence tools could help safety-net organizations close gaps created by massive cuts to Medicaid signed into law last year, experts said at the HIMSS conference.

By Emily Olsen • March 12, 2026

CVS to pay $118M to settle Medicare Advantage fraud allegations

The settlement announced by the Department of Justice on Wednesday comes after federal regulators accused Aetna of submitting inaccurate data to the CMS.

By Rebecca Pifer Parduhn • March 11, 2026

FDA clears repurposed GSK drug for ultra-rare brain disease instead of autism

Months after promising help for “hundreds of thousands of kids,” the FDA approved the decades-old medicine for a disease documented in less than 50 people.

By Kristin Jensen • March 11, 2026

Overpayments to Medicare Advantage plans are costing seniors billions, Joint Economic Committee finds

Congressional investigators found Medicare Part B premiums rose by more than $200 per member, totaling $13.4 billion in additional spending, due to the alleged overpayments. Payers slammed the report as flawed.

By Rebecca Pifer Parduhn • March 11, 2026

ARPA-H launches program to develop biosensors that can track multiple signals

The research initiative is part of a broader focus on wearables at the HHS.

By Elise Reuter • March 10, 2026

AI is moving at lightning speed. Can regulation keep up?

Artificial intelligence is swiftly evolving, forcing regulators to figure out how to oversee a technology that can act autonomously and potentially improve itself, experts said at the HIMSS conference in Las Vegas.

By Emily Olsen • March 10, 2026

Vinay Prasad, controversial FDA leader, to again depart agency

Prasad’s planned departure, expected at the end of April, culminates a tumultuous term in which he reworked vaccine guidelines and was criticized for his office’s stance on several rare disease drugs.

By Jonathan Gardner , Ben Fidler • Updated March 7, 2026

HHS adds cybersecurity guidance to healthcare sector self-assessment tool

Organizations can now use the online platform to test their readiness for digital security crises.

By Eric Geller • March 6, 2026

Hospitals urge regulators to halt drugmakers’ expanded 340B data policies

The American Hospital Association argues new policies from Eli Lilly and Novo Nordisk requiring providers to submit more claims data on dispensed 340B drugs is onerous and unlawful.

By Emily Olsen • March 5, 2026

HHS gets serious on information blocking enforcement

Nearly a decade after Congress banned information blocking, the HHS is making progress cracking down on health IT developers accused of the practice, an agency head said during a Senate subcommittee hearing.

By Sydney Halleman • March 5, 2026

Optum Rx, Caremark making ‘significant progress’ in settlement talks with FTC

It’s looking increasingly likely that the UnitedHealth and CVS drug middlemen will also make peace with federal regulators, after Cigna agreed to a sweeping settlement in the insulin lawsuit last month.

By Rebecca Pifer Parduhn • March 5, 2026

CMS receives record comments on controversial Medicare Advantage payment proposal

The Trump administration wants to keep MA rates flat next year and change how risk adjustment is calculated. Insurers had a lot to say about this, CMS officials shared Tuesday during an event in D.C.

By Rebecca Pifer Parduhn • March 4, 2026

CMS innovation center remains focused on mandatory models, officials say

CMMI Director Abe Sutton and CMS Administrator Dr. Mehmet Oz outlined how the administration aims to get more providers, especially poor-performing ones, into value-based models at a D.C. event on Tuesday.

By Rebecca Pifer Parduhn • March 4, 2026

State Medicaid budgets face $664B cut due to ‘Big Beautiful Bill’: study

Twenty states are projected to experience Medicaid budget reductions of 5% or more from the law’s cuts to the safety-net insurance program, according to the Rand analysis.

By Emily Olsen • March 3, 2026

Education Department urged to broaden ‘professional’ student definition

Professional students will be able to borrow $100,000 more than other graduate students, but a proposed rule would exclude certain healthcare fields, like advanced nursing and physician associates, from the higher cap. 

By Ben Unglesbee • March 3, 2026

Provider groups push to preserve some IT certification criteria, including AI ‘model cards’

A proposed rule would cull or revise dozens of health IT certification criteria, but providers say regulators should keep some of them to avoid shifting costs or compliance responsibilities back onto clinicians. 

By Emily Olsen • March 3, 2026

CMS threatens Elevance with Medicare Advantage sanctions

Federal regulators are planning to suspend enrollment in Elevance's MA plans at the end of March, in a rare and serious threat to the company’s finances.

By Rebecca Pifer Parduhn • March 3, 2026

Trump administration targets DME suppliers in fraud crackdown

The government plans a six-month moratorium on supplier enrollment in the Medicare program to find ways to stop what it called “longstanding instances of fraud, waste, and abuse” by certain companies.

By Susan Kelly • Feb. 27, 2026

How PBM reforms could push drugmakers into the pricing spotlight

The Consolidated Appropriations Act’s landmark PBM overhaul removes financial incentives tied to pharma list prices, potentially leaving drugmakers to defend their own practices.

By Alivia Kaylor • Feb. 27, 2026

Trump administration halts over $259M in Medicaid funds to Minnesota

The funds would be a fraction of the $11.8 billion in Medicaid funding the state receives from the federal government. The Trump administration said the action was part of a broader crackdown on fraud in federal healthcare programs.

By Sydney Halleman • Feb. 26, 2026

Trump’s State of the Union trumpets healthcare greatest hits, but no new policies

In his lengthy address Tuesday night, the president touted his efforts to make drugs and insurance more affordable but steered clear of hot-button issues like vaccine access and the GOP’s Medicaid cuts.

By Rebecca Pifer Parduhn • Feb. 25, 2026