Medicare & Medicaid
The court said Humana didn’t exhaust the administrative appeals process, though CMS has already rejected one appeal.
The AGs said a rule targeting 'improper' enrollments would cause widespread loss of insurance coverage and increase premiums.
The bill would double the federal investment in rural health care while reversing future changes to Medicaid hospital funding.
The agency is also proposing to phase out the Inpatient Only list (IPO) over a three-year period.
CMS will negotiate outcomes-based agreements with CGT manufacturers on behalf of state Medicaid agencies.
CMS says it also wants to calculate more accurate payment rates for certain services.
PBM provision, silver loading left out of final version of One Big Beautiful Bill Act due to Byrd Rule.
DOJ’s criminal healthcare-fraud unit is investigating how UnitedHealth deployed doctors and nurses to gather diagnoses that bolstered its payments, WSJ says.
AHA: "The number of individuals who will lose health coverage - cannot be simply dismissed as waste, fraud, and abuse."
Defendants include 96 doctors, nurse practitioners, pharmacists and other licensed medical professionals.