A coalition of five Medicaid beneficiaries, six physician and health organizations and the city of Columbus, Ohio, sued HHS Secretary Robert F. Kennedy Jr., CMS Administrator Mehmet Oz, MD, and their agencies Sept. 18, arguing CMS’ interim final rule on…

Nearly three in four small and mid-size employers that currently offer traditional group health insurance are considering dropping those benefits for 2027, driven overwhelmingly by rising premium costs, according to a September survey from eHealth. eHealth surveyed more than 500…

HCA Healthcare CFO Mike Marks said payers have outpaced hospitals on AI-driven claims processing, adding another layer to the friction hospitals face on denials, underpayments and prior authorization. “I know there’s a lot of talk about AI in the hospital…

Forty states and Puerto Rico have signed agreements to join the Generous Model, a Medicaid drug payment initiative that ties prices for certain prescription drugs to what other developed nations pay, CMS announced Sept. 18.  Four things to know: 1.…

Elevance Health is laying off 216 employees in Louisiana as part of the wind-down of its Medicaid business in the state. The layoffs are set to take effect by the end of the year at the insurer’s Metairie office, according…

The National Committee for Quality Assurance has named the highest-quality and most-effective health plans of 2026 based on clinical quality, patient experience and health plan accreditation status. The ratings were released Sept. 15 and draw on 2025 data from commercial,…

Five Medicare Advantage plans scored a full five stars in this year’s health plan rankings from the National Committee for Quality Assurance, up from three in 2025. An additional 15 plans, including five more Kaiser health plans from around the…

The national uninsured rate held steady at 7.9% in 2025, with 26.7 million people having no health coverage, according to Census Bureau data released Sept. 15. Beneath the unchanged national rate, the coverage mix shifted as Medicaid enrollment fell by…

The No Surprises Act’s independent dispute resolution process has now generated more than $22 billion in total costs since 2022, with dispute volume still accelerating and the courts, Congress and federal regulators all moving in different directions on how to…

CVS Health’s Aetna is expanding prior authorization bundles for cancer, available to some Medicaid members as of Sept. 1. The update impacts Medicaid members with providers in Oklahoma, Illinois, Maryland, New Jersey, Virginia, Florida, Kentucky and West Virginia who use…