Regulatory

Individual Market Insurers Requesting Largest Premium Increases in More Than 5 Years

Each spring and summer, health insurers submit rate filings to state regulators to justify premium changes for the coming calendar year. Several factors drive premium changes, and usually the cost of medical care (the prices of health services and the amount of care people are receiving) is the primary driver of premiums. However, heading into […]

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Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2025

The Medicare Part D program provides an outpatient prescription drug benefit to more than 50 million older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone prescription drug plans (PDPs) to supplement traditional Medicare and Medicare Advantage prescription drug plans (MA-PDs) that include drug coverage and other Medicare-covered benefits.

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Medicaid Cuts Could Have ‘Far-Reaching’ Healthcare, Economic Impacts: Study

Medicaid cuts could have “far-reaching” consequences for the healthcare sector and the broader economy, driving up preventable hospitalizations and excess deaths while cutting revenue for providers, according to research published in JAMA Health Forum. Coverage losses due to the massive tax and policy law recently signed by President Donald Trump are estimated to cause more

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The FDA Has Cleared More Than 1,200 Clinical AIs—and Submissions Are Increasing

The U.S. Food and Drug Administration (FDA) has now cleared 1,247 clinical artificial intelligence (AI) algorithms for direct patient care. The FDA updated its AI-enabled device approval list this week, which showed the regulatory agency is seeing rapidly increasing numbers of AI product submissions. More than 1,000 of these are specific to medical imaging, with

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Mallinckrodt Receives Necessary Ruling from Irish High Court to Combine with Endo, Inc.

Mallinckrodt plc announces that the Irish High Court has given the necessary ruling to enable its combination with Endo, Inc. (OTCQX: NDOI), advancing the companies’ plan to merge in a stock and cash transaction that will create a global, scaled, diversified therapeutics leader. The Court’s ruling is the final substantive legal step required for the

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CMS Proposes Eliminating the Inpatient Only List, 2.4% ASC Payment Rate Update for 2026

In a major regulatory development, the U.S. Centers for Medicare & Medicaid Services (CMS) is calling for the end of the Medicare Inpatient Only List (IPO). The agency floated those plans on July 15 when releasing its 2026 ASC payment system proposed rule. While there’s much to unpack in the more than 900-page proposed rule,

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Medicare Proposes ‘Efficiency’ Pay Cuts That Would Hit Highly Paid Specialists the Most

Medicare is proposing across-the-board cuts to what Trump administration officials believe are overpriced medical procedures, scans, and tests — a consequential decision designed to even the score between highly paid specialists and primary care doctors. The federal Medicare agency justified its action by saying that more than half of the 10,000 billing codes used by

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Trump 2.0 Backs Digital Health in Proposed CY2026 Physician Fee Schedule Rule

In its first proposed physician fee schedule rule of the second Trump administration, the Centers for Medicare and Medicaid Services (CMS) indicated that digital health technology, like telehealth and remote monitoring, have a role to play in the administration’s push to treat chronic disease. CMS signaled its commitment to digital health and built upon recent

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CMS Proposes 3.6% Pay Bump for Docs, Takes Aim at Chronic Conditions in Physician Fee Schedule

The Trump administration is proposing a pay bump for physicians in 2026, alongside new reforms that align with the agency’s Make America Healthy Again positioning. The Centers for Medicare & Medicaid Services released the proposed physician fee schedule on Monday evening, which would set the conversation factor, or the amount that Medicare pays per work

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House GOP Seeks More Medicaid, Medicare Cuts in Next Budget Bill

The ink is hardly dry on President Donald Trump’s $3.4 trillion tax and spending package and House Republicans are already at work on a follow-up budget bill coming this autumn. House Budget Committee Chairman Jodey Arrington in an interview with Bloomberg said Republicans will seek deeper cuts to Medicaid, new spending reductions in Medicare and

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