Healthcare’s agentic AI boom is outpacing governance: report
Patient safety could be at risk if agentic AI tools are rolled out without proper guardrails, Imprivata’s chief medical and growth officer warns.
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Why HaloMD became a target — and what its top lobbyist says critics get wrong
Patrick Velliky is confident the No Surprises Act is lowering out-of-network spending, despite research to the contrary. HaloMD’s chief external affairs officer responds to criticisms of his analysis, and of his company.
Mental health gap widens between employed and independent physicians: survey
Employed doctors report worse well-being than independent practitioners, with workload and administrative burden driving distress.
Federal watchdog accuses Humana, UnitedHealthcare Medicare Advantage plans of upcoding
Newly released HHS OIG audits of HumanaChoice and UnitedHealthcare of Wisconsin found both plans frequently exaggerated the health needs of their members, generating almost $180 million in overpayments over two years.
Express Scripts targeted by Arkansas pharmacies in first-of-its-kind lawsuit
Arkansas passed a law last year giving pharmacies the authority to sue PBMs for underpayments. Twelve independent pharmacies are now the first to take advantage of the new enforcement mechanism.
More health plans score 5 stars on NCQA ratings, but for-profits underperform
Eighteen plans scored a perfect 5 stars in the standards organization’s ratings for 2026, up from 11. There are no for-profits among them.
70% of Gen Z healthcare workers say they’re going to quit within the next year
Employers need to start offering more perks like education benefits in order to retain young workers, according to a survey from the Harris Poll. That’s notable for employers, who need to recruit talent to stave off workforce shortages, one expert said.
CMS to add more chronic conditions to ACCESS model in 2027
The Trump administration is expanding Medicare’s new technology-based payment experiment to cover more chronic conditions, including COPD, substance use disorder and tobacco cessation.
HHS adds new IDR entity as surprise billing disputes surge
Physio Solutions, which does business as medlitix, is the 17th company certified to settle out-of-network payment disputes under the No Surprises Act as arbiters face increasing scrutiny from researchers and lawmakers.
OIG urges crackdown on equipment suppliers in Medicare Advantage
The agency says the CMS and MA organizations aren’t doing enough to screen durable medical equipment providers, especially out-of-network companies that aren’t enrolled in Medicare.
2.3M young adults could lose Medicaid due to Big Beautiful Bill: study
Actual disenrollment will depend heavily on how easy states make it for young adults, who move frequently and participate in hard-to-track gig work, to prove they should stay enrolled, the Urban Institute found.
Conifer to lay off over 1,000 workers
The layoffs come months after CommonSpirit announced it was ending its service contract early and exiting its stake in the Tenet-owned revenue cycle company.
Oracle targets nurses with latest AI tool
Nurses in the U.S. can use Oracle’s clinical artificial intelligence agent to search for and navigate patient charts via voice commands and generate nursing summaries, the company announced Monday.
Johnson & Johnson requires providers to share claims data to get 340B discounts
The drugmaker is the latest to impose a reporting requirement on 340B providers, saying stricter guardrails are needed to prevent duplicative discounts.
Patient identity is the missing control in healthcare AI
Before you ask if the model is ready for patients, ask if the patient record is ready for the model.
The hidden cost of manual work in ambulatory care
Manual work quietly drains time, capacity and revenue. Here’s how ambulatory practices can respond.
Why hospital network segmentation projects stall and what that means for patient safety
Most health systems start network segmentation. Far fewer finish. Why that gap affects care.
Boston Scientific fully restores operations after cyberattack
CEO Mike Mahoney gave more details at a Thursday investor conference, saying the company likely lost orders while its plants and distribution centers were shut down.
More than half of hospitals still not fully compliant with price transparency rules: report
A record number of hospitals are fully sharing data on the cost of their services, thanks to the CMS stepping up enforcement. But there’s still a ways to go, according to PatientRightsAdvocate.org.
ARPA-H to invest $62M to build agentic AI agent for heart care
The funding could create a regulatory approval pathway for future applications of clinical-grade artificial intelligence.