This week, UnitedHealth Group faced two new investigations from federal lawmakers. The first was a senator’s probe into its Medicare Advantage billing practices, and the second was a Congressman's investigation into a decline in care quality at Optum-owned clinics in New York.
The Senate confirmed Robert F. Kennedy Jr. as secretary of the Department of Health and Human Services. Healthcare leaders hope he addresses issues relating to health coverage, drug costs, and more.
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Senators John Kennedy (R-Louisiana) and Eric Schmitt (R-Missouri) introduced a bill last week that would require ‘able-bodied adults’ without dependents to work or volunteer for at least 20 hours per week to receive Medicaid benefits.
CMS recently issued a statement saying that it's continuing the Medicare Drug Price Negotiation Program but is leaving the door open for potential changes. Experts weighed in on what changes could be made and what changes they would like to see.
The DEA recently released three rules regarding the remote prescribing of controlled substances. However, many telehealth advocates argue that two of these rules hinder access to care.
Contracts are now integrated into an end-to-end system, and efficiencies abound.
Earlier this week, the Federal Trade Commission released its second interim staff report on prescription drug middlemen. The report examines the impact of PBMs (specifically CVS Caremark, Express Scripts, and Optum Rx) on specialty generic drugs, highlighting substantial price markups by PBMs on medications for cancer, HIV, and other conditions.
HHS is proposing major changes to HIPAA for the first time in more than a decade, aiming to strengthen cybersecurity protocols for electronic health data. Healthcare cybersecurity leaders are mainly in favor of the proposal — though there are some concerns that smaller providers will struggle with the financial and operational burdens of compliance.
Families USA led a letter urging the new Congress, which was sworn in on Jan. 3, to protect Medicaid.
The Affordable Care Act's enhanced subsidies are at risk of expiring at the end of 2025, and healthcare leaders are worried about what could happen if Congress doesn’t renew them. For instance, more Americans would become uninsured, premiums would increase, and hospitals would be saddled with more bad debt due to uncompensated care.
Reach out to continue the conversation on how to most effectively detect, prevent, and correct this or other types of fraud, cybercrime, misconduct, and non-compliance.
U.S. healthcare organizations lose $1.9 million on average during each day of downtime following a ransomware attack, according to new research from Comparitech. Rebecca Moody, Comparitech’s head of data research, predicted that the rate of ransomware attacks in the healthcare sector will accelerate even more in 2025.
President-elect Donald Trump recently appointed former Paypal executive David Sacks as the White House’s first-ever czar for AI and cryptocurrency. Ryan Tarzy — CEO of Avandra Imaging, a federated network for de-identified imaging data — thinks this appointment could help accelerate the pace of innovation in the healthcare industry.
Senators Elizabeth Warren and Josh Hawley and Representatives Diana Harshbarger and Jake Auchincloss introduced the Patients Before Monopolies Act on Wednesday. It aims to prohibit the parent company of a PBM or insurer from owning a pharmacy business.
In a letter, Families USA and numerous other organizations called on Congress to extend the enhanced premium tax credits that are set to expire at the end of 2025.
After the FTC filed a lawsuit in September, accusing the three major pharmacy benefit managers of anticompetitive rebating practices related to insulin, the defendants reversed roles and became plaintiffs. In November, they countersued the agency, arguing that its lawsuit is unconstitutional.
