The One Big Beautiful Bill Act (OBBBA) will slash Medicaid spending by $900 billion over the next decade with an estimated 7.5 million people losing coverage. These shifts will hit health systems hard, especially those serving Medicaid expansion and undocumented…
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The U.S. Government Accountability Office found significant fraud risk in the ACA application process, according to a Dec. 3 agency report. Auditors applied for coverage under fictitious identities to test marketplace enrollment controls. The marketplace approved coverage for the four…
Aetna is bundling pharmacy prescriptions and medical procedures into a single clinical review, according to a Dec. 4 news release. Providers previously had to submit two prior authorizations, but, as of November, providers only have to file one medical review,…
The One Big Beautiful Bill Act is poised to slash Medicaid revenue by $25 billion annually, a 70% drop in operating margin for the average hospital. With redeterminations moving to every 6 months, patients are losing coverage. Payers are escalating…
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The Trump administration introduced plans to lower obesity drug costs for Medicaid and Medicare, but commercial insurance coverage of GLP-1s remains a concern. “There is some speculation that this initiative will help create downward pressure for drug manufacturers to lower…
New Jersey has finalized rules requiring state-regulated insurers to cap out-of-pocket costs on insulin, asthma inhalers and epinephrine auto-injectors. The state published the final regulations Dec. 1, implementing legislation Gov. Phil Murphy signed that made New Jersey the second state…
Medicare Advantage insurer Zing Health has filed a new lawsuit against HHS and CMS, alleging the agencies failed to remedy harms caused by its improper termination from the MA program last year. The insurer filed the complaint Nov. 26 in…
The 12 months since UnitedHealthcare CEO Brian Thompson was fatally shot have been among the most turbulent in UnitedHealth Group’s history. The company has cycled through senior executives, disclosed billions in unexpected medical costs, confirmed it is under criminal investigation…
Angle Health raised $134 million in series B funding to scale its benefits platform, according to a Dec. 3 news release. The company secured a mix of debt and equity, with total funding reaching nearly $200 million. Portage led the…
Healthcare education is moving fast. Executives are under pressure to keep compliance airtight while building skills that reduce turnover and improve care. Traditional, course-first learning alone is not meeting the moment, especially as roles evolve and technology changes how people…
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Presented by:
Lindsey Dangerfield
Product Marketing Manager, HealthStream
Mickey Sisselman
Sr. Solution Executive, HealthStream
