Federal judge vacates Trump admin restrictions on ACA gender-affirming care

The ruling keeps some protections for gender-affirming care in place, but also upholds several other controversial policies paring back the ACA.

By Sy Mukherjee • Aug. 19, 2026

Epic debuts instant prior authorization checks at 4 health systems

Ochsner Health, Froedtert ThedaCare Health, Denver Health and Summit Health are the first to adopt the application programming interface, which Epic says should speed up preapprovals for medical items and services.

By Jill Hughes • Aug. 18, 2026

Explore the Trendline➔

Payer/provider relationships

As M&A intensifies and companies embrace more holistic and value-based care models, partnerships have become more closely intertwined.

By Healthcare Dive staff

CVS adds JPMorgan data executive to board amid AI push

JPMorgan’s data and analytics chief is joining CVS’ board this fall, while the CEO of activist hedge fund Glenview Capital Management is leaving after a two-year stint.

By Rebecca Pifer Parduhn • Aug. 18, 2026

Centene CFO to step down at year-end

Chris Neczypor, the finance chief at Lincoln Financial, will succeed Drew Asher on Jan. 1. Asher plans to retire at the end of 2027.

By Jill Hughes • Aug. 17, 2026

Investor suit says UnitedHealth ignored governance, cybersecurity gaps for years

UnitedHealth misled investors, shuttered an internal Medicare billing audit and ignored cybersecurity lapses that led to the historic Change Healthcare cyberattack, according to a lawsuit filed by two shareholder groups.

By Jill Hughes • Aug. 17, 2026

Health advocacy group sues AMA to make billing codes public

PatientRightsAdvocate.org is challenging the physician association’s copyright of the current procedural terminology, or CPT, system. Use of the codes is required by law, and that means they should be freely available, per the suit.

By Rebecca Pifer Parduhn • Aug. 14, 2026

Premiums, out-of-pocket costs dominate Americans’ healthcare concerns: survey

Respondents were split on who should solve the issues, with Democrats more likely to say the federal government and Republicans more likely to name insurers, according to the Commonwealth Fund.

By Sy Mukherjee • Aug. 14, 2026

Prior authorization denials vary widely among insurers, first-of-its-kind data shows

Denials ranged from 2% to 25% among insurers last year, according to a KFF analysis of new prior authorization data that the CMS forced insurers to release.

By Jill Hughes • Aug. 14, 2026

5th Circuit strikes down No Surprises billing benchmark in win for providers

The court ruled last week that insurers can’t include ghost rates or exclude bonus payments in calculating a metric used to determine reimbursement for out-of-network bills. That’s set to further inflate payouts to providers.

By Rebecca Pifer Parduhn • Aug. 13, 2026

‘Way off the reservation’: Brookings researchers slam assumptions in CMS work requirements rule

The rule made it harder for sick Medicaid enrollees to prove they’re exempt from work requirements than many expected. The CMS got sued. And now, the agency is being accused of fudging the data at the center of the rule.

By Rebecca Pifer Parduhn • Aug. 12, 2026

Humana taps ex-Johns Hopkins exec as Medicaid leader

James “J.P.” Holland is taking the reins of Humana’s Medicaid business, a key growth area for the company, starting this coming Monday. It’s part of a broader leadership transition announced late last year.

By Rebecca Pifer Parduhn • Aug. 11, 2026

Insurers want to hike small businesses’ premiums by 14% next year: KFF

It’s becoming harder for small employers to offer insurance coverage, and another year of double-digit premium increases won’t help. Insurers say their hands are tied.

By Rebecca Pifer Parduhn • Aug. 7, 2026

Complete Health to pay $14M to settle Medicare Advantage fraud allegations

The value-based primary care provider submitted false diagnosis codes to the CMS for three years, inflating its reimbursement by millions of dollars, according to the DOJ.

By Rebecca Pifer Parduhn • Aug. 5, 2026

Sentara moves to end Anthem contracts in Virginia

Nearly 380,000 patients could go out of network with the health system if the commercial, Medicare and Medicaid contracts lapse.

By Sy Mukherjee • Aug. 5, 2026

CVS triples net income thanks to booming health plan profitability

“There’s not much more to say for CVS’ 2Q other than... wow,” one analyst commented. CVS also announced a new GLP-1 deal with Eli Lilly.

By Rebecca Pifer Parduhn • Aug. 5, 2026

Hospitals feel the pinch as more patients lose insurance

Half a year after enhanced Affordable Care Act subsidies expired, hospitals say more patients are going uninsured. That’s starting to drag their finances.

By Sydney Halleman • Aug. 4, 2026

Out-of-Network claims are costing you more than you think

88% of IDR disputes go to providers. See how health plans can fix OON claims first.

By Mark Noel, SVP & GM, AMPS ClaimInsight • Aug. 3, 2026

Trump administration tries again to institute rebates in 340B

The Trump administration is again pushing to include rebates in the drug discount program after a failed attempt earlier this year. Hospitals railed against the announcement, saying it would burden already strapped providers.

By Sydney Halleman • July 31, 2026

Judge rejects states’ bid to pause Medicaid work requirements

A federal judge last week said he wasn’t convinced that regulation detailing work requirements would cause irreparable harm to states. Still, the court will continue to hear the case.

By Emily Olsen • July 31, 2026

Cigna’s profits jump thanks to employer-sponsored plans

Cigna increased its 2026 earnings outlook following the second quarter, unbothered by inflated costs for surprise billing dispute resolutions reported by its peer UnitedHealth.

By Rebecca Pifer Parduhn • July 30, 2026

CMS to end subsidies for Medicare drug plan premiums

The CMS said the program, which went into effect last year to stabilize Part D premiums and enrollment, isn’t needed anymore. Some enrollees could see higher premium increases in 2027 as a result, according to one researcher.

By Emily Olsen • July 29, 2026

ICHRA adoption slowed by ACA exchange costs, instability

Many employers are considering the coverage arrangements, but worries about the ACA marketplaces — including potentially high costs for workers — are making them hesitant to move forward, according to a survey.

By Emily Olsen • July 29, 2026

Humana to exit more Medicare Advantage plans in 2027

The insurer is laser-focused on reaching margin targets, and will sacrifice some plans with lower returns next year to do so, CFO Celeste Mellet said.

By Rebecca Pifer Parduhn • July 29, 2026

‘Back on track’: Centene swings to more than $1B in profit in Q2

The managed care giant raised its 2026 earnings outlook for the second time this year following the results, which its CFO called “fantastic.”

By Rebecca Pifer Parduhn • July 28, 2026

Included Health to acquire Firefly Health

Included is hoping that Firefly’s offerings will help set it apart in a crowded employee benefits space, especially as employers become increasingly open to alternative health plan arrangements.

By Rebecca Pifer Parduhn • July 28, 2026