Category: Healthcare Finance News

Senate removes PBM provision from tax and spending bill

House Republicans are reportedly expected to pass President Trump’s spending bill today after holding a marathon voting session during the night.
All are watching to see what remains in the final version of the “Big Beautiful Bill” before it heads to T…

Sharp HealthCare reduces workforce by 1.5%, citing economy

Citing changing economic conditions, Sharp HealthCare has announced it will be cutting 315 employees from its payrolls as part of a reduction of 1.5% of its workforce. 

Optum Rx scraps reauthorization requirements for more than 60 drugs

Optum Rx has added more than 60 additional drugs to a list for which it is eliminating reauthorization requirements, including products for HIV, behavioral health and hypertension.

Senate boosts rural hospital fund to offset Medicaid cuts

The Senate version of the “Big Beautiful Bill” could come up for a vote as early as today in the House.
House passage is the last hurdle before the bill reaches President Trump’s desk for his signature.

324 charged in connection with $14.6 billion in healthcare fraud

The U.S. Department of Justice has completed its 2025 National Health Care Fraud Takedown, which resulted in criminal charges against 324 defendants for their alleged participation in various healthcare fraud schemes involving more than $14.6 billion.

CMS notifies patients impacted by data breach

The Centers for Medicare and Medicaid Services is notifying Medicare beneficiaries whose personal information may have been involved in a data incident affecting Medicare.gov accounts.
CMS said it identified suspicious activity related to the unauthori…

CMS launches prior authorization pilot for Original Medicare

The Centers for Medicare and Medicaid Services has announced a prior authorization program pilot for original Medicare.

6.4% payment decrease proposed for home health agencies

Home health agencies are facing a proposed 6.4% decrease in Medicare payments in 2026, compared to 2025.

CMS proposing 1.9% hike for ESRD facilities

The Centers for Medicare and Medicaid Services has issued a proposed rule that would increase total payments to all end-stage renal disease (ESRD) facilities by about 1.9%, bringing the ESRD Prospective Payment System base rate to $281.06.

Michigan doctor sentenced in $6.3 million Medicare fraud scheme

A Michigan doctor has been sentenced to four years in prison for a $6.3 million Medicare fraud scheme in which elderly and disabled patients were allegedly sent thousands of orthotic braces they didn’t need, according to the U.S. Department of Justice.