A mom in Peoria, Illinois, took her 3-year-old to the ER one evening last December. While they were waiting to be seen, the toddler seemed better, so they left without seeing a doctor. Then the bill came.
Category: Health Insurance
Franciscan Health repurposing hospital for behavioral health
Franciscan Health Dyer in Indiana will transition its hospital to a behavioral health services facility by the end of 2027, the health system has announced.
The transition, approved by the Franciscan Alliance Board of Trustees, aims to meet the growing…
Proposed Coverage of Anti-Obesity Drugs in Medicare and Medicaid Would Expand Access to Millions of People with Obesity
This policy watch examines the implications of new proposed regulations that would allow Medicare and require Medicaid to cover drugs used to treat obesity, including a relatively new class of highly effective but costly drugs known as GLP-1s.
CMS announces obesity drug coverage in Medicare, Medicaid
On Tuesday, the Centers for Medicare and Medicaid Services announced a proposed rule for coverage of obesity drugs in Medicare and Medicaid, starting in 2026.
After notice and comment rulemaking, the rule would need to be finalized under the Trump Admi…
Mount Sinai leans into AI with new research center
Mount Sinai Health System in New York is embracing artificial intelligence with the recently announced opening of the Hamilton and Amabel James Center for Artif
UnitedHealthcare wins lawsuit over star ratings
UnitedHealthcare has won its lawsuit against the Centers for Medicare and Medicaid Services over the calculation of Medicare Advantage star ratings.
A federal court in Texas on Friday ordered CMS to recalculate UnitedHealth’s 2025 star ratings without …
Florida’s Deloitte-Run Computer System Cut Off New Moms Entitled to Medicaid
Florida discovered a glitch in its Deloitte-run Medicaid eligibility system. The problem, alleged in court testimony, led to new mothers wrongly losing their insurance coverage.
Anesthesiologist sentenced to 190 years for IV bag tampering
A Dallas anesthesiologist who was found guilty of injecting dangerous drugs into patient IV bags, leading to one death and numerous cardiac emergencies, has been sentenced to 190 years in prison, according to the U.S. Department of Justice.
Senators urge action on physician payment cut before end of lame duck session
With only three weeks left in the legislative calendar, 41 senators have signed a letter urging Senate leaders to prevent the 2.8% physician pay cut scheduled to go into effect on January 1.
Payers, providers increasing investments in AI
More than half of health system leaders and insurance executives are calling artificial intelligence an “immediate priority,” and 73% of organizations said they were growing their financial commitments to the technology, according to a new survey, “Ins…
