Government
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Cities sue to block ACA rule for increasing uninsured rate
City leaders said the regulation risks undermining the Affordable Care Act exchanges and adding new costs for local governments. Now, they’re suing to overturn the rule.
By Sydney Halleman • June 8, 2026 -
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Over half of Medicaid enrollees say they’re unaware of upcoming work requirements
Many enrollees don’t know they’ll need to report work, education or volunteer hours starting in less than six months in order to stay covered, according to a recent survey from the Health Management Academy.
By Emily Olsen • June 8, 2026 -
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TrendlineSurprise Billing
Federal legislation banning surprise bills has hit a barrage of roadblocks, complicating efforts to protect consumers from unexpected out-of-network charges.
By Healthcare Dive staff -
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Ascension closes AmSurg deal following FTC scrutiny
Regulators cleared the nonprofit’s $3.9 billion AmSurg acquisition — but with conditions.
By Sydney Halleman • June 5, 2026 -
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FTC requires Ascension divestitures in $3.9B AmSurg deal
Ascension needs to sell seven surgery centers if it wants the deal to close, regulators said. Ascension, which is pursuing the AmSurg acquisition as part of a larger financial turnaround, said it was pleased with the compromise.
By Rebecca Pifer Parduhn • June 2, 2026 -
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Eli Lilly issues data sharing ultimatum to 340B hospitals
Select hospitals have refused to share data to prove they’re not double-dipping drug discounts, Lilly said. Hospitals, which have until Monday to comply, are urging the government to intervene.
By Rebecca Pifer Parduhn • June 2, 2026 -
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CMS releases Medicaid work requirements guidance for states
The highly anticipated interim final rule weighs in on key issues for states hustling to operationalize work requirements before the 2027 deadline. But there’s still some gray area — and lots of critics.
By Rebecca Pifer Parduhn • Updated June 2, 2026 -
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Massachusetts sues UnitedHealthcare for alleged Medicaid fraud
The state claims UnitedHealthcare inflated the sickness of seniors enrolled in MassHealth managed care plans to reap at least $100 million in improper payments.
By Emily Olsen • June 1, 2026 -
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Elevance again avoids Medicare Advantage sanctions, but threat remains
The CMS pushed back sanctions until July 1 after Elevance made progress on fixing faulty data submissions for its privatized Medicare plans. But the company still has more to do, regulators said.
By Rebecca Pifer Parduhn • June 1, 2026 -
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‘A missed opportunity’: Payers lash out against surprise billing final rule
A highly anticipated rule finalized Thursday meaningfully improves how insurers and providers settle disputes over out-of-network bills. But payers say it doesn’t go far enough to curb alleged provider abuse.
By Rebecca Pifer Parduhn • May 29, 2026 -
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Uninsurance rate holds flat in 2025: CDC
The percentage of Americans without insurance last year remained relatively stable compared to 2024. However, more people are likely to lose coverage in the years to come due to healthcare spending cuts from the “Big Beautiful Bill.”
By Emily Olsen • May 29, 2026 -
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Surprise BillingTrump administration reforms surprise billing dispute resolution
The industry has been waiting for regulators to finalize the rule amid snowballing concerns about how insurers and providers settle out-of-network claims. The regulation is aimed at making that process more efficient.
By Rebecca Pifer Parduhn • May 28, 2026 -
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CVS sues to challenge new Tennessee PBM-pharmacy breakup law
The law, which would prohibit PBM conglomerates from owning or operating pharmacies, illegally boots out-of-state companies from Tennessee’s pharmacy market, CVS argued in a suit filed Friday.
By Rebecca Pifer Parduhn • May 27, 2026 -
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HHS launches AI-backed health fraud crackdown
The department will use AI to examine audits from states and other federal grant recipients, and potentially withhold funds if they aren’t able to fix errors.
By Emily Olsen • May 22, 2026 -
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Vertical integration doesn’t appear to lead to higher drug costs in Medicare, HHS OIG finds
However, data was limited, so it’s too early to make firm conclusions, the watchdog clarified. That didn’t stop the largest PBM lobby from jumping on the report as concrete proof that consolidation doesn’t drive up prices.
By Rebecca Pifer Parduhn • May 21, 2026 -
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Trump administration proposes crackdown on Medicaid state-directed payments
The proposed rule codifies cuts outlined in the GOP’s “One Big Beautiful Bill,” but also takes other steps to restrict supplemental Medicaid payments. The CMS said it would save the federal government over $500 billion if finalized.
By Sydney Halleman • May 21, 2026 -
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Lawmakers mull Medicare physician pay reform to tamp down consolidation
Physician pay hasn’t kept up with the costs of providing care, pushing independent practices to sell to health systems and likely increasing costs, witnesses said during a House subcommittee hearing.
By Emily Olsen • May 21, 2026 -
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ACA deductibles reach record high as membership losses slated to continue: KFF
A fuller picture is emerging of how the expiration of enhanced subsidies is affecting the Affordable Care Act exchanges and the millions of Americans who rely on them for coverage.
By Rebecca Pifer Parduhn • May 20, 2026 -
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Senate Democrats move to roll back Medicare AI prior authorization pilot
Lawmakers introduced a resolution to end the WISeR model, which Democrats say is delaying and denying care to seniors.
By Emily Olsen • May 20, 2026 -
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HHS reorganizes Office for Civil Rights with religious bent
The civil rights enforcement arm of the HHS will reinstate a division dissolved during the Biden administration that focuses on conscientious objections and religious issues in health and social programs.
By Sydney Halleman • May 20, 2026 -
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Employer to pay $4.25M to settle claims it failed to consider vaccine exemptions
Recent enforcement involving COVID-19 vaccines appears to go hand in hand with the Trump administration’s broader prioritization of Christian issues.
By Emilie Shumway • May 19, 2026 -
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Tenet hospitals, Leapfrog spar over legal fees in hospital ratings case
The Tenet-owned hospitals want Leapfrog to pay $10.5 million in legal fees after a judge agreed that the nonprofit unfairly deflated their ratings. The penalty would “cast a specter of financial ruin” over the nonprofit, Leapfrog said.
By Sydney Halleman • May 19, 2026 -
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CMS finalizes major changes to ACA exchanges, including greater access to catastrophic plans
The Trump administration continues to open the doors to the cheap, high-deductible coverage, to the worry of insurance experts and stakeholders in the healthcare industry.
By Rebecca Pifer Parduhn • May 18, 2026 -
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Surprise BillingEmployer groups, unions urge Trump administration to reform No Surprises dispute resolution
Providers are reaping high award amounts, and arbiters have “structural conflicts of interest” that incentivize a high volume of disputes, driving up healthcare costs for employers and patients, the groups wrote.
By Emily Olsen • May 18, 2026 -
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Supreme Court preserves access to abortion pill by mail
The ruling maintains access to mifepristone while litigation continues. The drug can still be prescribed at pharmacies or by mail without requiring in-person visits.
By Sydney Halleman • May 15, 2026 -
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CMS launches initiative to speed electronic prior authorization adoption
The effort, part of the agency’s ambitious Health Tech Ecosystem, aims to accelerate the industry’s progress before requirements on electronic prior authorization go into effect next year.
By Emily Olsen • May 14, 2026
