Drug pricing 2026 forces are reshaping pharmacy economics through Medicare negotiations, FTC actions, and federal pricing models.
Oakland, Calif.-based Kaiser Permanente is suing nine liability insurers for breach of contract, alleging they have refused to cover any portion of its $556 million settlement with the federal ...
AI-powered dual enrollment helps payors scale D-SNP enrollment 3× faster, reduce revenue leakage, and lower acquisition ...
Florida’s growing senior population drives demand for cost-conscious coverage as 2026 healthcare costs, Medicare rules ...
Compensation reforms prohibit price- or rebate-linked PBM revenue in Part D, pushing flat service-fee models and broadly capturing affiliates such as rebate GPOs and aggregators. Reform priorities aim ...
New rule elevates medical-dental integration and highlights the role of primary care in oral health outcomes Smiles for ...
The Tungsten+PLUS™ platform delivers comprehensive downstream services, including MFP claims reconciliation, dispute resolution, and compliance-ready workflows. The platform provides Health Systems ...
Section 6225 of the Consolidated Appropriations Act of 2026 (CAA 2026), enacted on February 3, 2026, fundamentally changes Medicare's treatment of hospital off-campus provider-based departments.
In recent years, medical guidelines and national policies have pushed hospitals to offer more palliative care to patients who are seriously ill. This has led to a major rise in palliative care use, ...
Patients on traditional Medicare plans were less likely to have access to certain stroke-preventing care versus those on Medicare Advantage but were also more likely to receive intensive post-stroke ...
Opinion
AHA Submits Comments on CMS Proposed Rule on Prohibiting 'Sex-Rejecting Procedures' for Children
The AHA today submitted a comment letter responding to the Centers for Medicare & Medicaid Services’ proposed rule that would prohibit hospitals participating in the Medicare and Medicaid programs ...
Attorneys at Sidley Austin LLP examine the issue of drug price reporting rules under Medicaid and enforcement risks under the False Claims Act.
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