Health Care Dive

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.