Policy & Regulations

This channel includes news coverage of healthcare policy and regulations set by Congress, the states, Centers for Disease Control and Prevention (CDC), the Department of Health and Human Services (HHS), U.S. Food and Drug Administration (FDA), and medical associations and societies. 

Medicare money payment

CMS’ AI program to add prior authorizations to traditional Medicare; new bill aims to stop it

President Donald Trump’s administration argues that their “WISeR” model will eliminate unnecessary testing and save Medicare money. But eight Democrats opposing it think it will only bring Medicare Advantage chaos to Part A and Part B.

Congress Senate Washington D.C. DC

Republicans win shutdown showdown—Senate agrees to funding deal without ACA subsidy extension

With eight Democrats agreeing to the Republican-backed deal that reverses the firings of federal workers, the Senate now has the 60 votes needed for the bill to advance. The rehirings will include the 1,200 workers fired at the Department of Health and Human Services. 

UnitedHealthcare UHC UnitedHealth

UnitedHealthcare bucks Medicare, ends reimbursement for most RPM services

Starting in 2026, patients covered by UnitedHealthcare's Medicare Advantage and commercial plans will not have care reimbursed for instances of remote patient monitoring unless they have diagnosed heart failure or are pregnant and experiencing hypertension. The shift stands at odds with traditional Medicare, which added new claims codes for providers to use next year.

Waymo Creative Commons Image

Doctor sues Waymo after AI flags him as a terrorist

Nasser Mohamed, MD, a neurologist who operates a clinical practice in San Francisco, said an artificial intelligence system used by the autonomous taxi company led to him being denied multiple rides. He is seeking injunctive relief.

pharmaceutical drug approval process

Some reviewers opposed FDA's approval of new drug for life-threatening disease

When the FDA approved elamipretide for the treatment of Barth syndrome, not everyone agreed with the agency's decision. 

TrumpRx.gov Screenshot

GLP-1 weight loss drugs will now be covered by Medicare and Medicaid—and available at a discount through TrumpRx

Novo Nordisk and Eli Lilly have agreed to sell their popular Wegovy and Zepbound injectables through TrumpRx.gov for a discounted rate, as the White House promises that Medicaid and Medicare plans will begin covering the costs. 

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Ohio AG investigating business practices of nonprofit safety net hospital

Authorities said in a court filing that they received a complaint about Northeast Ohio Neighborhood Health Services’ business practices. The health system owes more than $12 million to creditors, and investigators are asking to see its financial records.

California State Capitol Sacramento

California chooses Innovaccer's AI to improve Medicaid outcomes for vulnerable populations

The company will analyze claims data from over 2 million people enrolled in Medi-Cal. The data will be used for compliance reporting and to improve patient care coordination.