Health Care Dive

The agency kept a contested definition of “professional” student that excludes fields like graduate nursing and physical therapy from higher loan caps. Healthcare groups say the regulation could worsen workforce shortages.

The Cornhusker State is the first to roll out work requirements under the GOP’s “Big Beautiful Bill,” well in advance of the law’s 2027 deadline. Between 20,000 and 40,000 people are expected to lose Medicaid as a result.

Executives said Tenet’s focus on managing expenses and growing high-acuity service lines helped it withstand poor volumes that battered some of its peers in the first quarter.

The insurer plans to say goodbye to the ACA exchanges after this year, and is exploring a potential sale of its controversial claims review subsidiary. Both businesses were more trouble than they were worth, executives said.

Healthcare organizations are struggling to navigate the compliance landscape amid a pullback in federal enforcement, a wave of state legislation and emerging voluntary initiatives, experts say.

During a high-profile congressional hearing on Tuesday, one lawmaker said hospitals charge “an insane amount” for care. Still, the CEOs largely passed the buck, arguing their prices are justified.

Native, Hispanic and Black communities experienced worse health access and affordability issues than white people in most states, according to a new report from the Commonwealth Fund.

Humana’s foremost priority is returning to 3% Medicare Advantage margins in 2028, CEO Jim Rechtin repeatedly promised investors on Wednesday morning. Still, the insurer’s profits dipped in the first quarter.

The risk of being sued is higher among certain specialties like surgeons, and increases the longer doctors practice medicine, according to the medical association’s new report.

The insurer, a mainstay in government programs like Medicaid and the ACA exchanges that have been wracked by higher spending, successfully controlled costs in the quarter, leading to $1.5 billion in profit.

The hit was in line with HCA’s expectations. The hospital operator is the first of its peers to detail financial impacts from the expiration of more generous subsidies in Affordable Care Act plans.

Aligning electronic data submission requirements for prior authorizations is one prong of the insurance industry’s commitment to reform the unpopular preapprovals.

The private equity-backed anesthesia provider bought and bullied its way to market dominance in Texas, driving up prices for patients, the FTC alleged. The parties have now reached a deal, though USAP will not admit liability.

The report compiled by Sen. Maria Cantwell, D-Wash., found procedures in the state that were previously approved within around two weeks now take four to eight weeks to be authorized.

Though chatbots could have some benefits for mental health access, the physician lobby argued “immediate attention is required” to avoid harming patients looking for support.

The pathway is designed to reduce the delay between FDA authorization and Medicare coverage for certain Class II and Class III breakthrough medical devices.

The insurer beat analyst expectations for adjusted earnings in the first quarter. But steeper Medicaid membership losses than expected could saddle Molina with higher costs down the line.

The data, compiled by the Brookings Center on Health Policy, shows that average prices for some services like imaging were seven-times higher than Medicare prices.

A program that got caught up in HHS’ decision to abandon mRNA research was revived by a public-private coalition and is now beginning a large, late-stage test that could support a future approval.

A program that got caught up in HHS’ decision to abandon mRNA research was revived by a public-private coalition and is now beginning a large, late-stage test that could support a future approval.

The company argues the offering is a more comprehensive approach to weight management, allowing patients to receive ongoing support care and transparent pricing on prescriptions.

The retailer, which at one point had 14 MedWise sites, is divesting its nine-location network to Saint Francis Health System.

Hospitals and clinics told regulators that switching to rebates in the 340B drug discount program would impose costs that would outweigh the program’s benefits.

Hayley Park will oversee BSCA’s prescription drug programs. The insurer has worked to overhaul its pharmacy management model in a bid to lower drug costs.

Premium hikes, plan redesigns and other efforts from the Minnesota-based company to wrangle medical spending bore fruit in the first quarter. UnitedHealth’s stock jumped accordingly.

The influential physician association surveyed thousands of doctors and found that burnout last year was lower than in 2024 or 2023. Still, certain specialties, especially those on the front lines of care, face an elevated risk of burning out.

Republicans largely praised the HHS secretary’s track record during a marathon of House hearings last week, but some GOP lawmakers raised concerns about proposed budget cuts to the National Institutes of Health.

Employers, lawmakers and more said regulators should hustle to get disclosure mandates for the controversial drug middlemen across the finish line, while PBMs slammed the rule as illegal, unnecessary and anticompetitive.

The agency said it developed concerns about the limited evaluation process for the devices after gaining experience with the alternative pathway.

If confirmed by the Senate, Schwartz could finally fill a void for an agency that’s cycled through multiple leaders over the last year.

The AI scribe company said information from the New England Journal of Medicine and the JAMA Network will allow providers to more easily access the latest medical research.

About 14% of ACA enrollees didn’t pay premiums in January, a higher rate than usual and one that suggests ACA enrollment will continue to decline, according to Wakely.

Healthcare affordability continues to keep employers up at night. More businesses are shopping for new healthcare vendors as a result, according to the Purchaser Business Group on Health.

The agency’s decision to hold an advisory committee meeting on the topic comes after HHS Secretary Robert F. Kennedy Jr. told podcaster Joe Rogan he’s a “big fan” of peptides.

Customers can now connect to third-party providers for weight management services through Walmart’s digital health platform, then turn around and fill GLP-1 prescriptions at its retail pharmacy.

Study authors, who reviewed data from New York, said rising rates of overturned claims suggest that insurers’ claims review processes might not be working as intended, and policymakers should consider getting involved.

Dr. Janice Nevin will step down in September after more than 12 years in the health system’s top role. ChristianaCare’s former chief legal counsel will take her place.

The rollout marks the first deployment of the records system at a VA medical center in years after technical problems plagued the project. In total, 13 medical centers are scheduled to receive the Oracle EHR in 2026.

When workers delay care because of cost, it could hurt employers more in the long run, other research suggests.

It’s a major victory for controversial billing intermediary HaloMD, which cheered the court’s decision. Elevance said it plans to appeal.

Participants will receive set reimbursement for managing Medicare beneficiaries’ chronic conditions, like diabetes, chronic kidney disease and hypertension.

Paola Arbour will stay at Tenet on a part-time basis to provide transition and support services through early 2028.

Drugs were left out of a 2024 rule streamlining prior authorizations by making decisions electronic and requiring payers to turn them around more quickly. The Trump administration is looking to address that gap.

Regulators are proposing to send $1.4 billion more to acute care hospitals and debut the first nationwide, mandatory payment model to lower the cost of joint replacements. Hospitals pushed back.

The agency showcased dozens of tools Thursday, about 8 months after the CMS first announced the initiative that aims to ease health data sharing and improve access to digital health and AI products.

Persistent barriers are still hindering drug development for a host of menopause symptoms.

A group of 19 states and Washington, D.C., sued over the department’s sweeping layoffs and reorganization last year. A federal judge on Tuesday struck down the HHS’ bid to dismiss the lawsuit.

The telehealth provider said hackers gained access to a third-party customer service platform, but medical records remained secure.

About 2 in 10 said they at least sometimes use AI chatbots to get health information, but only 18% considered their responses highly accurate, according to the survey published by the Pew Research Center.

A resilient medtech industry navigating the fallout from President Donald Trump’s trade wars is taking proactive steps to manage tariff costs as the administration’s policies continue to evolve.

The health system claims the policy, which reduces reimbursement for some inpatient hospital stays, violates federal law and its reimbursement contract with Aetna. The insurer disagreed with Jefferson’s allegations.

Employers are turning to Individual Coverage Health Reimbursement Arrangements to cut costs, but rising premiums and instability on the individual market pose challenges.

Companies raised $4 billion in the first quarter, an increase of $1 billion over the prior year, according to Rock Health. But nearly 60% of the capital deployed came from 12 large deals.

The Trump administration is requesting about $111 billion in discretionary funding for the HHS, nearly $16 billion less than its budget in 2026.

Regulators cut almost a dozen metrics that factor into the quality ratings and reverted back to an older and more generous bonus system. MA plans will get more than $18 billion in additional payments over the next decade as a result.

Lawmakers are considering bills that would unwind the state’s oversight over Ballad, the largest state-sanctioned hospital monopoly in the U.S. The FTC argues that’s a bad idea.

Clinicians’ use of an AI scribe was associated with 13 fewer minutes each day inside electronic health records and 16 fewer minutes on documenting patient care, according to the research published in JAMA.

The insurer had until the end of March to correct faulty data submissions or be hit with severe sanctions from the CMS. But regulators agreed to give Elevance more time to comply.

Hospitals in 16 states have sued the department, arguing a 2023 final rule underpays hospitals that treat a disproportionate number of low-income patients.

Senators praised a recent CMS proposal aimed at reducing payments in MA, but urged the agency to work with Congress and go further.

The Trump administration said the revamp, which reverses the HHS’ 2024 restructuring of its technology functions, will better coordinate AI, data and cybersecurity policy across the department.

Eli Lilly is expanding its commitment to artificial intelligence-driven drug development, signing a deal with Hong Kong-based Insilico to develop and commercialize experimental drugs in preclinical development.