Articles and Blogs

NATIONAL 4 senators push CMS to tackle Medicare Advantage upcoding: Bloomberg 7 health systems with boosted outlooks 131 hospitals sue HHS over DSH cuts: 5 notes ACA plans denied 19% of in-network claims in 2024: report AHA urges CMS to limit hospital burden in fraud crackdown, calls for MA scrutiny Bipartisan bill would cap... READ MORE

NATIONAL 1 in 3 adults using AI chatbots for healthcare advice: KFF Academic medical models are under financial strain: 5 things to know Aetna, Elevance, Humana May Be Sued In Alleged Kickback Scheme, Judge Says AHA cautions CMS on provider ID rule implementation AHA: FBI warns of Iranian hacks via Telegram app AHA urges... READ MORE

NATIONAL 5 new things to know about the No Surprises Act: GAO report Amazon expands Health AI beyond the One Medical platform Amazon launches health AI agent on its website, expands free virtual care to 200M Prime members Big Pharma Gets Win in RFK Jr. Vaccine Pause, Unsure If It Lasts Bipartisan bill introduced... READ MORE

NATIONAL 84% of primary care providers say they have key role in mental healthcare: Survey Aetna to pay $118M to settle Medicare Advantage upcoding claims A.I. Chatbots Want Your Health Records. Tread Carefully. Epic sued over claims MyChart fragments patient medical records Federal Medicaid fraud probe spreads to 10 states FDA vaccine chief to... READ MORE

NATIONAL 8 “Cs” drive physician buy-in to high-value patient care 14 payers recently fined by states Aetna fined $550K for mental health parity violations AHA warns of Cisco cybersecurity vulnerability AMA creates new maternity care coding system Amazon launches Amazon Connect Health Amid fast-moving Medicaid changes, CMS vet offers providers and states advice Antikickback... READ MORE

NATIONAL 3 big questions surrounding the Rural Health Transformation Program 15 states sue HHS over childhood vaccination schedule change 16 health systems affected by Oracle Health data breach ACOG publishes 1st guidance on diagnosing endometriosis AHA recommends ‘zero trust’ for cybersecurity AHA urges HHS to align AI rules with existing healthcare regulations CDC’s No.... READ MORE

NATIONAL 41% of rural hospitals in red ahead of Medicaid policy shift 2 senior HHS leaders to exit roles 5 CMS moves shaping the ASC industry Change Healthcare breach: The cyberattack’s impact 2 years later Federal judge strikes down FTC rule expanding premerger reporting requirements Health systems must connect with patients in more meaningful... READ MORE

NATIONAL 130,000 individuals sign up for organ donation via MyChart 9 ways health systems are rethinking behavioral care 18 states push for reinstatement of SNF minimum staffing 10 years after CMS’ first mandatory bundled payment model, what did it actually build? 85% of healthcare leaders plan to boost agentic AI investment: Deloitte AHA, FBI... READ MORE

NATIONAL 4 Joint Commission moves in January AMA alters position on gender-affirming surgeries for minors Cardiovascular care demand fuels investments from hospitals Cigna CEO predicts steady PBM margins amid settlement, health law CMS makes ‘huge’ shift emphasizing falls in Special Focus Facility selection process CMS proposes paying hospitals that buy US-made drugs, supplies CMS... READ MORE

NATIONAL Children’s Hospital Association teams with Vizient CMS official defends flat Medicare Advantage rate proposal for 2027 CMS pitches stricter oversight of organ procurement groups: 6 takeaways CMS proposes nearly flat Medicare Advantage payments for 2027: 5 notes CMS proposes excluding chart reviews from MA risk scoring in 2027 payment rule CMS seeks input... READ MORE