The new lawsuit, filed on behalf of five Medicaid enrollees and a swath of provider groups, says the CMS narrowed exemptions ...

CVS Health’s Aetna insurance division is combining all the different preapproval requirements for cancer care into just one unified request, as payers continue to reform one of the biggest pain points ...

Despite a $2.8B settlement over BlueCard program disputes, five HCA-affiliated hospitals say the program still traps them in red tape.

Patrick Velliky is confident the No Surprises Act is lowering out-of-network spending, despite research to the contrary.

Plans are scrutinizing every controllable cost. But one of the largest costs is healthcare’s greatest blind spot: the full ...

Newly released HHS OIG audits of HumanaChoice and UnitedHealthcare of Wisconsin found both plans frequently exaggerated the ...

About 12 million Americans can’t access telehealth because broadband is unavailable or slow, according to new research. Most ...

The insurer is still working on strategies to ensure its MA markets remain as profitable as possible, but it’s confident in ...

A judge in Texas last week approved a bankruptcy plan for CVS’ Omnicare, winding down the pharmacy services division after it sold its business operations for $250 m ...

Patient safety could be at risk if agentic AI tools are rolled out without proper guardrails, Imprivata’s chief medical and ...

Arkansas passed a law last year giving pharmacies the authority to sue PBMs for underpayments. Twelve independent pharmacies ...

Employed doctors report worse well-being than independent practitioners, with workload and administrative burden driving ...