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President-elect Donald Trump's playbook on healthcare regulations for his second term could dramatically change how care is covered and delivered. [ABSTRACT FROM AUTHOR]

Anthem Blue Cross Blue Shield is rescinding its new policy on anesthesia after the company began receiving fresh scrutiny. [ABSTRACT FROM AUTHOR]

The two drugs treat sickle cell disease, the stated first priority of the new CMS model set to begin in January. [ABSTRACT FROM AUTHOR]

Keep up with some of the latest headlines in the payer space with our ongoing monthly roundup for November. [ABSTRACT FROM AUTHOR]

Stick with this tracker for the latest layoff and workforce updates from across healthcare. [ABSTRACT FROM AUTHOR]

CMS made some concessions to hospitals who strongly criticized the kidney transplant model proposed rule in May. [ABSTRACT FROM AUTHOR]

With time running out before leaving office, the Biden admin is proposing a rule to have Medicare and Medicaid cover anti-obesity medications. [ABSTRACT FROM AUTHOR]

UnitedHealthcare will get to claim victory over CMS and receive a recalculated score from the agency, potentially giving the insurer more in QBPs. [ABSTRACT FROM AUTHOR]

Stick with this tracker for the latest layoff and workforce updates from across healthcare. [ABSTRACT FROM AUTHOR]

The health equity index might get rolled back in the next administration and there may be a bipartisan consensus forming around Medicare Advantage. [ABSTRACT FROM AUTHOR]

Legislation that gives a president wide-reaching power to financially harm any nonprofit an administration deems as terrorist supporting passed out of the House of Representatives Nov. 21. [ABSTRACT FROM AUTHOR]

TV personality and surgeon Dr. Oz is Trump's choice to run the Centers for Medicare & Medicaid Services. [ABSTRACT FROM AUTHOR]

Major PBMs are countersuing the Federal Trade Commission, claiming the agency is biased and has too much authority to upend the industry. [ABSTRACT FROM AUTHOR]

Keep up with some of the latest headlines in the payer space with our ongoing monthly roundup for October. [ABSTRACT FROM AUTHOR]

National healthcare groups have signed on in opposition to a House bill that would soon grant President Donald Trump the ability to undermine nonprofits and remove their tax-exempt status, civil li [ABSTRACT FROM AUTHOR]

Blue Cross Blue Shield of Massachusetts is further strengthening its offerings for women. [ABSTRACT FROM AUTHOR]

CMS released favorable savings results for ACO REACH model participants as NAACOS begins to push for the program's extension through 2030. [ABSTRACT FROM AUTHOR]

Unwaveringly, Oscar CEO Mark Bertolini expects the ACA subsidies to be extended one way or another. [ABSTRACT FROM AUTHOR]

NeueHealth posted another quarterly net loss as the company tries to dig itself out of a huge hole. [ABSTRACT FROM AUTHOR]

Hot off of a robust star ratings performance. Clover Health feels its in a strong position. The company recorded a net loss of $8.8M this quarter. [ABSTRACT FROM AUTHOR]

Stick with this tracker for the latest layoff and workforce updates from across healthcare. [ABSTRACT FROM AUTHOR]

Harris and Trump have two separate visions on the ACA, prescription drug prices and reproductive rights. [ABSTRACT FROM AUTHOR]

Eligible members in the program can skip Function Health's long waitlist and gain access to more than 100 lab tests aimed at preventing disease. [ABSTRACT FROM AUTHOR]

An exclusive special report scrutinizes legislative priorities ahead of the presidential election and the lobbying groups pushing for action. [ABSTRACT FROM AUTHOR]

Elevance Health researchers might have an explanation for lower-than-expected Medicare spending: the proliferation of Medicare Advantage plans. [ABSTRACT FROM AUTHOR]

Keep up with some of the latest headlines in the payer space with our ongoing monthly roundup for September. [ABSTRACT FROM AUTHOR]

Alignment Healthcare raised membership yet again following its third-quarter earnings, but the company is still not profitable. [ABSTRACT FROM AUTHOR]

Accountable care organizations saved Medicare $2.1 billion, the largest yearly savings in program history, in 2023, CMS revealed Oct. 29. [ABSTRACT FROM AUTHOR]

Molina Healthcare posted an adjusted earnings per share of $6.01 and $10.34 billion in total revenue. [ABSTRACT FROM AUTHOR]

A watchdog questions whether MA payers are either creating diagnoses out of thin air to inflate Medicare payments or are not providing adequate care. [ABSTRACT FROM AUTHOR]

Anthem Blue Cross Blue Shield of New York members struggle to receive mental health care due to the insurers' ghost network, a lawsuit claims. [ABSTRACT FROM AUTHOR]

The AMA and an Illinois medical group claim data analytics firm MultiPlan is systematically destroying local providers through low reimbursement rates [ABSTRACT FROM AUTHOR]

Recent price transparency regulations have caused prices to converge for outpatient services but led to more discrepancy for inpatient services, according to findings from Turquoise Health. [ABSTRACT FROM AUTHOR]

Centene is joining the ranks of frustrated insurers who say misclassified secret shopper calls are causing profound financial damage. [ABSTRACT FROM AUTHOR]

The U.S. federal government is attempting to ease access to birth control products and HIV prevention drugs in a newly proposed rule. [ABSTRACT FROM AUTHOR]

Stick with this tracker for the latest layoff and workforce updates from across healthcare. [ABSTRACT FROM AUTHOR]

A report from Sen. Richard Blumenthal, D-Connecticut, found that the country's biggest MA insurers use artificial intelligence to control costs. [ABSTRACT FROM AUTHOR]

Clover subsidiary Counterpart Health hired David Tsay as chief medical officer. We spoke with Tsay to hear his thoughts on what makes Clover unique. [ABSTRACT FROM AUTHOR]

CareNu's subsidiary is launching an Institutional Special Needs Medicare Advantage plan in Florida for patients with chronic illness. [ABSTRACT FROM AUTHOR]

UnitedHealth and Humana saw star ratings decrease, whereas insurtechs celebrated their scores. [ABSTRACT FROM AUTHOR]

It's harder than ever for Medicare Advantage plans to score well on star ratings. Here's how they performed for 2025. [ABSTRACT FROM AUTHOR]

UnitedHealth, CVS Health and Cigna all view FTC chair Lina Khan as unfair toward PBMs and say she should be removed from the FTC's antitrust lawsuit. [ABSTRACT FROM AUTHOR]

Stick with this tracker for the latest layoff and workforce updates from across healthcare. [ABSTRACT FROM AUTHOR]

CMS is looking to further refine its new Medicare $2 Drug List Model to make prices more predictable for Part D beneficiaries. [ABSTRACT FROM AUTHOR]

The feds and top medical groups are weighing in on a No Surprises Act case, disagreeing with a previous ruling that could make the law powerless. [ABSTRACT FROM AUTHOR]

Companies like Omada Health and Noom are urging Congress to pass the Prevent Diabetes Act to expand access to virtual diabetes prevention. [ABSTRACT FROM AUTHOR]

Texas is suing drug manufacturers and the big three PBMs for insulin pricing tactics that adversely impacted the state's diabetes patients. [ABSTRACT FROM AUTHOR]

One call center interaction is at the crux of a lawsuit UnitedHealthcare is bringing forward against CMS because of a reduced star rating score. [ABSTRACT FROM AUTHOR]

Rep. Dingell wants to expand dental coverage to tens of millions of Americans. The goal is gaining popularity among voters and elected Democrats. [ABSTRACT FROM AUTHOR]

CMS is looking to increase feedback from drug companies and foster better communication with pharmacies during the next round of drug negotiations. [ABSTRACT FROM AUTHOR]