Legal experts say the effort signals a broader shift toward data-driven enforcement, as regulators ramp up their scrutiny of telehealth companies and billing automation software.
Disagreements between providers and payers have been moving into the courtroom over the past few weeks.
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Tennessee lawmakers recently passed a bill banning PBMs from owning pharmacies in the state, though like a similar Arkansas law, it is expected to face legal challenges if enacted.
Lawmakers introduced the Medicare Advantage Improvement Act of 2026 to tighten prior authorization rules, boost transparency, and curb practices that delay care.
The American Medical Association is urging Congress to add safeguards for AI mental health chatbots amid safety concerns, while noting their potential to expand access.
At the Medicarians Conference, Ricardo Carcas, assistant special agent in charge of the Office of Investigations, discussed cases of fraud in the ACA and how the DOJ is combatting it.
Designed to reduce manual docket work by prioritizing what litigators need most: on-demand full docket summarization that explains the whole case to date, followed by on-demand document summaries for filing triage, and AI-powered natural language searching for faster search and retrieval.
HeartFlow, which makes AI tools to analyze cardiac images, sued its rival Cleerly, alleging infringement on six patents. Cleerly is pushing back.
Rep. Greg Murphy introduced a bill that would require out-of-pocket prescription drug spending to count toward patients’ deductibles and out-of-pocket maximums regardless of where the drugs are purchased.
The lawyers had never met before, which makes this story all the more touching.
President Donald Trump’s 2027 budget proposes deep healthcare cuts, raising concerns about harm to patients and research.
As federal borrowing caps tighten financing options for law students, one organization is stepping in to negotiate the terms they can't secure alone.
The cases mark a broader push by regulators to scrutinize how health systems use 'all-or-nothing' contracts to shape insurance networks and patient access.
The case highlights a broader clash between providers and Medicare Advantage plans over 'downcoding' short hospital stays and controlling costs.
A group of 131 hospitals has sued HHS over a CMS policy they say improperly reduces Medicare disproportionate share hospital (DSH) payments. The lawsuit is the latest in a decade-long legal battle over how the agency counts patient days and calculates payments for safety net hospitals.
The Department of Justice filed an antitrust lawsuit against NewYork-Presbyterian, alleging the hospital used ‘all-or-nothing’ contracts that blocked lower-cost plans and limited competition.
Industry leaders say the No Surprises Act is protecting patients from surprise bills, but its Independent Dispute Resolution system is being overused and exploited, driving up costs and prompting calls for reform.