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News
CMS Ends Part D Premium Stabilization for 2027
5+ hour, 40+ min ago (388+ words) WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services will end a temporary premium-stabilization program for standalone Medicare drug plans after 2026, returning Part D to traditional market conditions as insurers prepare their 2027 offerings. CMS disclosed the change July 28 as part of its…...
CMS Defers $1 Billion in Medicaid Payments to States
1+ week, 1+ day ago (429+ words) WASHINGTON, D.C. — The Department of Health and Human Services and the Centers for Medicare & Medicaid Services last week deferred more than $1 billion in federal Medicaid payments to California and Minnesota while reviewing claims the Trump administration says require additional documentation before…...
CMS Proposes Medicare Payment Changes to Cut Drug, Imaging Costs
4+ week, 1+ day ago (523+ words) WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services has proposed sweeping changes to Medicare outpatient payment policies for 2027, including lower payments for certain hospital drugs and imaging services, in a move the agency estimates could save beneficiaries and taxpayers billions of…...
Lyric Pushes AI Into Claims Payments as Health Plans Target Costs
4+ week, 2+ day ago (331+ words) PHILADELPHIA, PA — Healthcare technology company Lyric reports that major health insurers are using new artificial intelligence-driven orchestration capabilities in its Lyric42 platform to coordinate payment decisions and reduce administrative costs tied to claims processing and payment disputes. The platform’s new capabilities…...
Hidden River Backs Northstar-Alta Merger to Expand Senior Living Platform
1+ mon, 3+ week ago (361+ words) RADNOR, PA — Hidden River Strategic Capital has invested in Northstar Senior Living in connection with its merger with Alta Senior Living, providing financing to support the integration of the two senior living management companies and future expansion efforts. The combined…...
No Surprises Act Overhaul Cuts Arbitration Fees, Expands Access
2+ mon, 3+ day ago (483+ words) WASHINGTON, D.C. — Federal regulators have finalized sweeping changes to the No Surprises Act’s dispute resolution system, reducing arbitration fees by more than 85% and revising procedures intended to address a backlog that has generated more than 5 million payment disputes since the program…...
Pennsylvania Officials Push Insurance Protections for Small Businesses
2+ mon, 6+ day ago (233+ words) HARRISBURG, PA — Pennsylvania officials on Wednesday urged small business owners to review insurance coverage and fire prevention measures as rising operational risks and disaster-related losses continue to threaten business continuity across the state. The Pennsylvania Insurance Department and the Office…...
GEICO Agrees to Revise Pennsylvania Cancellation Policies After AI Review Probe
2+ mon, 1+ week ago (393+ words) HARRISBURG, PA — The Pennsylvania Office of Attorney General reached an agreement with GEICO requiring changes to the insurer’s policy cancellation and underwriting review practices after a state investigation found a West Philadelphia driver lost coverage following an artificial intelligence-assisted review…...
New PA Tax Credit Could Ease Healthcare Costs for Workers
2+ mon, 1+ week ago (499+ words) HARRISBURG, PA — Pennsylvania lawmakers are advancing a proposal that would give small businesses a new state tax credit for helping employees pay for health insurance, an effort supporters say could expand coverage as more residents lose access to affordable plans....
Nearly Half of Denied Health Claims Overturned in Pa.
3+ mon, 4+ week ago (345+ words) HARRISBURG, PA — Hundreds of Pennsylvanians have gained access to previously denied health care coverage through a state-run appeal process that overturns nearly half of eligible insurance denials. Since 2024, Pennsylvania’s Independent External Review process has overturned about 48 percent of eligible denied…...