mailitics

Category: Insurance

  • STAT+: Trump can’t break free from vaccine politics

    STAT+: Trump can’t break free from vaccine politics You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. And you may find yourself climbing a StairMaster next to RFK Jr. Send news tips and vague Talking…

  • STAT+: CMS halts enrollment in Elevance’s Medicare Advantage plans, citing years of misconduct

    STAT+: CMS halts enrollment in Elevance’s Medicare Advantage plans, citing years of misconduct Elevance Health will no longer be able to enroll people into its Medicare Advantage plans starting March 31, according to a new, harshly worded suspension notice from the Centers for Medicare and Medicaid Services. CMS is imposing the punishment after Elevance failed…

  • STAT+: Cigna, extending reach into prescription drugs, acquires major pharmacy used by hospitals

    STAT+: Cigna, extending reach into prescription drugs, acquires major pharmacy used by hospitals Cigna has acquired CarepathRx, a large pharmacy backed by private equity that dispenses prescription drugs to nearly 10% of U.S. hospitals. The acquisition, discovered by STAT in a review of Cigna’s financial filings, reinforces the company’s push to control more of the…

  • STAT+: Drugmakers lay out their legal arguments against Trump’s drug pricing experiments

    STAT+: Drugmakers lay out their legal arguments against Trump’s drug pricing experiments WASHINGTON — The pharmaceutical and biotech industries are pushing back against two Trump administration proposals that would test plans to lower drug prices in Medicare by aligning them with the prices paid in other rich countries.  Their comments preview arguments that they might…

  • STAT+: The federal directory of doctors and hospitals is coming this year

    STAT+: The federal directory of doctors and hospitals is coming this year After years of grand ambitions, the federal government disclosed that it is months away from rolling out a centralized list of doctors and hospitals filled with up-to-date contact and insurance information. Details of how the national provider directory will work are scant —…

  • STAT+: Medicare Advantage growth dwindles for a second straight year

    STAT+: Medicare Advantage growth dwindles for a second straight year The Medicare Advantage program continues to bring in more older adults and people with disabilities, but not nearly at the same rates from just a few years ago. Almost 35.5 million people were enrolled in a Medicare Advantage plan as of Feb. 1, up roughly…

  • STAT+: The messaging war over Medicaid cuts

    STAT+: The messaging war over Medicaid cuts You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. Dr. Oz seems to have invited Jeffrey Epstein to a Valentine’s Day party in 2016, about eight…

  • STAT+: Trump officials push for skimpier coverage in ACA marketplaces

    STAT+: Trump officials push for skimpier coverage in ACA marketplaces Trump health officials are proposing changes that would water down the options for people who buy their own health insurance through Affordable Care Act marketplaces. The proposals, released this week and which would go into effect in 2027, prioritize making ACA premiums as low as…

  • STAT+: TrumpRx: Hype or real savings?

    STAT+: TrumpRx: Hype or real savings? You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. Did you snack on HHS-approved MAHA-mole while shaking to Bad Bunny’s Spanish-language celebration of Puerto Rican and Latin…

  • What to know about TrumpRx, the Trump administration’s prescription drug platform

    What to know about TrumpRx, the Trump administration’s prescription drug platform President Trump on Thursday night is planning to announce the launch of TrumpRx, the website that he and his aides have touted for months as a platform aimed at lowering prescription drug prices.  The website, which uses technology from health care company GoodRx, is…

  • STAT+: New rule would force PBMs to disclose drug rebates and other fees

    STAT+: New rule would force PBMs to disclose drug rebates and other fees Pharmacy benefit managers face new, sweeping requirements to disclose all the different ways they get money from providing drug coverage. The proposed rule from the Department of Labor published on Thursday would be a significant change for an industry that shields prescription…

  • STAT+: Trump’s latest deal: $600 million of tech company discounts to help implement Medicaid work requirements

    STAT+: Trump’s latest deal: $600 million of tech company discounts to help implement Medicaid work requirements Ten technology vendors are offering $600 million worth of discounts to states that pick them to help implement Medicaid work requirements, the Trump administration announced Thursday, signaling how lucrative they think the sweeping change could be.  Mehmet Oz, administrator…

  • STAT+: States are the next vaccine battleground

    STAT+: States are the next vaccine battleground You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. I’d call it a xeet-down, but I can’t tell who won this heated exchange on X between…

  • STAT+: Trump administration signals there’s widespread desire to curb Medicare Advantage

    STAT+: Trump administration signals there’s widespread desire to curb Medicare Advantage Health insurers have endured a litany of problems with Medicare Advantage over the past three years. They were optimistic things would turn around with the Trump administration in charge. Tough luck, for now. The administration stunned Medicare Advantage insurers and their investors by proposing…

  • STAT+: UnitedHealth limps into 2026 with a smaller business and fresh challenges

    STAT+: UnitedHealth limps into 2026 with a smaller business and fresh challenges UnitedHealth Group enters 2026 limping financially after one of the most turbulent years in the company’s history, but executives at the health insurance and services giant made it clear they will cut their way to higher profits. On Tuesday, UnitedHealth said revenue would…

  • STAT+: HHS spending bill caught up in ICE debate

    STAT+: HHS spending bill caught up in ICE debate You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. To those in the path of this winter storm: Are you rethinking dry January yet?…

  • STAT+: Health insurance execs shift blame for costly, confusing health care system

    STAT+: Health insurance execs shift blame for costly, confusing health care system Health insurance executives agree that the U.S. health care system is overpriced, wasteful, and confusing. And they also agree that those problems are someone else’s fault. On Thursday, the CEOs of America’s largest health insurance companies appeared before Congress to both justify their…

  • STAT+: What’s in Congress’ sweeping health care deal: PBM reform, telehealth, science funding

    STAT+: What’s in Congress’ sweeping health care deal: PBM reform, telehealth, science funding WASHINGTON — Congress has reached a deal on several health care policies, including a crackdown on drug-industry middlemen, transparency measures for hospital billing, pediatric cancer research measures, and Medicare coverage of multi-cancer screening tests. Those measures are part of a bill to…

  • STAT+: Trump releases health care plan amid pressure over affordability

    STAT+: Trump releases health care plan amid pressure over affordability WASHINGTON — President Trump on Thursday released a hodgepodge of health care policies that would create new price-control power over pharmaceutical companies, but that otherwise wouldn’t fundamentally overhaul America’s existing system, as he faces mounting pressure to address the cost of insurance and care. The…

  • STAT+: Negotiations over ACA subsidy bill drag on

    STAT+: Negotiations over ACA subsidy bill drag on You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. Inspirational scribbles from baristas have never inspired me, but HHS Deputy Secretary Jim O’Neill was moved…

  • STAT+: UnitedHealth has turned Medicare Advantage coding into ‘profit-centered strategy,’ Senate report finds

    STAT+: UnitedHealth has turned Medicare Advantage coding into ‘profit-centered strategy,’ Senate report finds UnitedHealth Group’s colossal size has helped the conglomerate turn the way patients are coded in the Medicare Advantage program into “a major profit-centered strategy, which was not the original intent of the program,” according to a new report released Monday from the…

  • STAT+: House passes ACA subsidy extension as bipartisan negotiations heat up in Senate

    STAT+: House passes ACA subsidy extension as bipartisan negotiations heat up in Senate WASHINGTON — The House voted 230 to 196 to pass a three-year extension of enhanced Affordable Care Act premium subsidies, with 17 Republicans joining all Democrats in favor. Five Republicans did not vote. That the House considered the matter at all shows…

  • STAT+: HHS slashes vaccine recommendations

    STAT+: HHS slashes vaccine recommendations You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. We’re almost healthy again, according to RFK Jr., though I’m certainly not in top form after my holiday break.…

  • Federal health officials slash recommended childhood vaccinations under Trump’s directive

    Federal health officials slash recommended childhood vaccinations under Trump’s directive WASHINGTON — Federal health officials are unilaterally reducing the number of recommended pediatric immunizations in response to an order from President Trump, the most significant reshaping of the vaccine schedule since Trump took office and empowered health secretary Robert F. Kennedy Jr., a longtime critic…

  • STAT+: Three major health care policy issues to watch in 2026

    STAT+: Three major health care policy issues to watch in 2026 WASHINGTON — Health care figured prominently in the first year of President Trump’s second term, and it’ll likely play an even bigger role leading up to the 2026 midterm elections.  The shift back to health care politics has been somewhat surprising. Although Republicans were…

  • STAT+: Trump moves to require lower drug prices in Medicare

    STAT+: Trump moves to require lower drug prices in Medicare You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. The NIH director did the Pete & Bobby fitness challenge, but I didn’t see…

  • STAT+: Major pharma companies may avoid Medicare experiments’ forced price cuts

    STAT+: Major pharma companies may avoid Medicare experiments’ forced price cuts Many of the largest drugmakers may be exempt from Medicare pilot programs intended to force them to lower some of their prices, potentially undermining the effort and depriving American patients of cheaper drugs. Several of the 14 pharmaceutical companies that have struck individual drug-pricing…

  • Trump administration’s plan to shrink vaccine schedule sends health sector scrambling

    Trump administration’s plan to shrink vaccine schedule sends health sector scrambling WASHINGTON — A possible Trump administration effort to change the childhood vaccine schedule has left hospital leaders, health policymakers, and pediatricians scrambling to navigate what could be the most significant changes to the American vaccine program in decades. The administration had planned to announce…

  • STAT+: Trump administration proposes Medicare pilots to lower drug prices on par with peer countries

    STAT+: Trump administration proposes Medicare pilots to lower drug prices on par with peer countries WASHINGTON — The Trump administration proposed two Medicare pilot programs to reduce prices for branded drugs bought at pharmacy counters and administered in doctor offices. If the administration moves forward, the programs could slash Medicare spending on prescription drugs by…

  • STAT+: Pharmaceutical industry evades drug price transparency, again

    STAT+: Pharmaceutical industry evades drug price transparency, again Drug manufacturers and pharmacy benefit managers received a holiday gift from President Trump on Friday: They still will not have to publicly post the actual prices of prescription drugs, more than five years after federal law required them to do so. Net drug prices — the amounts…

  • STAT+: UnitedHealth proclaims audits show it has ‘robust’ procedures, in contrast to findings of independent reviews

    STAT+: UnitedHealth proclaims audits show it has ‘robust’ procedures, in contrast to findings of independent reviews UnitedHealth Group said Friday that the consultants it hired to audit its operations, including its practice of applying lucrative diagnosis codes to older adults’ records, found they’re not only “robust,” but “industry leading.”  While the reports give a veneer…

  • STAT+: House set to vote on bills to ban gender-affirming care for young people

    STAT+: House set to vote on bills to ban gender-affirming care for young people Republicans in Congress are making a renewed push before the end of the year to pass major federal restrictions to gender-affirming care for trans minors.  The House is set to consider two bills this week, before lawmakers depart for their holiday…

  • STAT+: House juggles options for extending ACA subsidies

    STAT+: House juggles options for extending ACA subsidies You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. Since the election, Cheryl Hines hasn’t spoken to Larry David, her on-screen husband of 24 years…

  • STAT+: Medicare routes $16 billion to insurers to offset high drug costs

    STAT+: Medicare routes $16 billion to insurers to offset high drug costs The federal government has sent a record $16 billion to health insurers that sell Medicare drug plans, a flashing red sign that prescription drug spending is blowing up far beyond what government officials and insurance experts had expected. The good news for Medicare…

  • STAT+: ACA premium spike looms as Senate votes fail, House bill faces long odds

    STAT+: ACA premium spike looms as Senate votes fail, House bill faces long odds WASHINGTON — Senators on Thursday failed to pass legislation aimed at controlling health insurance costs for people with Affordable Care Act plans after dueling partisan bills were voted down mostly along party lines. Four Republicans voted for the Democratic bill, while…

  • STAT+: Major health insurers to skip J.P. Morgan conference, again

    STAT+: Major health insurers to skip J.P. Morgan conference, again For a second straight year, the nation’s largest health insurance companies will not be formally presenting at January’s J.P. Morgan Healthcare Conference, the industry’s premier investor event. Centene, Cigna, CVS Health, Humana, Molina Healthcare, and Oscar Health are not on the initial agenda for the…

  • STAT+: Medicare Advantage plans to gain $13 billion under Trump changes to star ratings

    STAT+: Medicare Advantage plans to gain $13 billion under Trump changes to star ratings Medicare Advantage insurers scored a Thanksgiving gift, as President Trump’s Medicare agency added back a bonus system that rewards health plans with consistently high marks. The Centers for Medicare and Medicaid Services also is proposing to eliminate a dozen star ratings…

  • STAT+: Major health insurers like Humana, UnitedHealth are cutting broker commissions to avoid costly Medicare enrollees

    STAT+: Major health insurers like Humana, UnitedHealth are cutting broker commissions to avoid costly Medicare enrollees Major health insurers are taking drastic steps to discourage older adults from signing up for their private Medicare plans as they seek to boost profits, drawing the ire of insurance brokers and state regulators. Humana, UnitedHealthcare, Anthem, and Centene,…

  • STAT+: Trump weighs plan to extend extra ACA subsidies for two years

    STAT+: Trump weighs plan to extend extra ACA subsidies for two years WASHINGTON — In an about-face, the White House is weighing a proposal to extend the Affordable Care Act enhanced subsidies that Democrats have been clamoring for since last year. ACA health insurance enrollees face a spike in premium payments if Congress does not…

  • STAT+: An extension of extra ACA health insurance subsidies looks increasingly unlikely

    STAT+: An extension of extra ACA health insurance subsidies looks increasingly unlikely WASHINGTON — Prospects are not looking good for an extension of the extra tax credits that have helped more Americans buy insurance plans in the Affordable Care Act’s marketplaces. Republicans don’t agree among themselves on a proposal, and Democrats don’t like any of…

  • STAT+: A revelatory profile of RFK Jr.

    STAT+: A revelatory profile of RFK Jr. You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. I haven’t read Olivia Nuzzi’s new book, but I dare say my favorite line about her relationship…

  • STAT+: Cassidy pitches his alternative to extending extra ACA subsidies

    STAT+: Cassidy pitches his alternative to extending extra ACA subsidies WASHINGTON — Sen. Bill Cassidy (R-La.) is pitching Democrats on his compromise to make Affordable Care Act marketplace plans affordable without extending the extra tax credits that currently lower premium payments. Cassidy, the chair of the Senate health committee, is among the team of Republican…

  • STAT+: Fate of ACA subsidies still clouded after deal to reopen the government

    STAT+: Fate of ACA subsidies still clouded after deal to reopen the government WASHINGTON — Democrats failed to achieve their main objective of extending enhanced Affordable Care Act tax credits in return for reopening the government. The result is that ACA subsidies will remain front and center into December and possibly next year. With a key…

  • STAT+: Trump renews a Republican battle cry: Repeal Obamacare

    STAT+: Trump renews a Republican battle cry: Repeal Obamacare Over the weekend, in the face of the longest federal government shutdown in history, a familiar refrain has arisen from President Trump and other Republicans: Repeal Obamacare. Republicans have long said Democrats’ Affordable Care Act is to blame for skyrocketing health care costs and what they…

  • STAT+: Cassidy drops into Liver Meeting to talk of shutdown, insurance overhaul and vaccines

    STAT+: Cassidy drops into Liver Meeting to talk of shutdown, insurance overhaul and vaccines WASHINGTON — On day 39 of the longest government shutdown in U.S. history, Sen. Bill Cassidy (R-La.) said he is still working toward finding bipartisan compromise on health care costs.  In a surprise appearance Saturday at the annual American Association for…

  • STAT+: UnitedHealthcare drops remote monitoring coverage in defiance of Medicare policies

    STAT+: UnitedHealthcare drops remote monitoring coverage in defiance of Medicare policies Beginning in January, UnitedHealthcare will no longer pay physicians to remotely monitor the data that patients collect at home about chronic conditions like hypertension. The updated medical policies for both Medicare and commercial health plans from the country’s largest insurer were posted in September…

  • STAT+: Seven burning questions about Trump’s big deal for cheaper weight loss drugs

    STAT+: Seven burning questions about Trump’s big deal for cheaper weight loss drugs WASHINGTON — The Trump administration’s deal to expand access to and lower the cost of weight loss drugs has left industry leaders, public health experts, and patients with a host of open questions. The administration’s agreements with Eli Lilly and Novo Nordisk…

  • STAT+: Children’s hospital lobby shifts strategy amid MAHA’s rise in Washington

    STAT+: Children’s hospital lobby shifts strategy amid MAHA’s rise in Washington WASHINGTON — As long-revered health institutions come under new scrutiny in President Trump’s Washington, one powerful group is shifting its strategy. The Children’s Hospital Association, which represents more than 200 hospitals and spends millions on lobbying each year, announced Tuesday a new messaging approach…

  • STAT+: UnitedHealth pays its own physician groups 17% more than outside ones, study shows

    STAT+: UnitedHealth pays its own physician groups 17% more than outside ones, study shows UnitedHealth Group pays its own physician practices much more than it pays competing practices, a new study finds, reinforcing STAT’s own analysis on the subject and presenting fresh evidence that the conglomerate may be skirting a rule designed to curb health…

  • Delays and uncertainty around SNAP; health care subsidies expire

    Delays and uncertainty around SNAP; health care subsidies expire WASHINGTON — The crises at the heart of the government shutdown fight in Washington were coming to a head Saturday as the federal food assistance program faced delays and millions of Americans were set to see a dramatic rise in their health insurance bills. The impacts on basic needs — food…

  • STAT+: Cigna stock nosedives on news that ending PBM rebates will lower that segment’s profit

    STAT+: Cigna stock nosedives on news that ending PBM rebates will lower that segment’s profit The stock market pummeled Cigna on Thursday after the company’s leaders revealed that their new plan to ditch pharmacy benefit rebates will lower that segment’s profit in the coming years. By midmorning, the company’s stock had plunged more than 15%. …

  • STAT+: Will Optum Real really end the payer vs provider AI wars?

    STAT+: Will Optum Real really end the payer vs provider AI wars? You’re reading the web edition of STAT’s AI Prognosis newsletter, our subscriber-exclusive guide to artificial intelligence in health care and medicine. Sign up to get it delivered in your inbox every Wednesday.  Multiple people have told me they’re now planning to see “Doctor Moloch,” the…

  • STAT+: UnitedHealth wants to employ more of its doctors

    STAT+: UnitedHealth wants to employ more of its doctors After assembling the largest collection of doctors in the U.S., UnitedHealth Group is switching strategies in an effort to improve its financial performance. The company plans to revamp its enterprise of 90,000 clinicians into one more heavily weighted toward employed physicians, rather than affiliated doctors, executives…

  • STAT+: Blue Cross plans to target doctors for overcharging. Physicians are furious

    STAT+: Blue Cross plans to target doctors for overcharging. Physicians are furious With the help of a computer algorithm, the state’s biggest health insurer says it will scrutinize doctors who frequently bill it for the most expensive patient visits. It will then unilaterally cut payments to physicians it concludes charged too much. Targeting what it…

  • Opinion: Is new insurance company downcoding long overdue or a travesty? STAT readers weigh in

    Opinion: Is new insurance company downcoding long overdue or a travesty? STAT readers weigh in First Opinion is STAT’s platform for interesting, illuminating, and provocative articles about the life sciences writ large, written by biotech insiders, health care workers, researchers, and others. To encourage robust, good-faith discussion about issues raised in First Opinion essays, STAT…

  • STAT+: Trump’s IVF deal spurs hopes — and adjustments — across fertility sector

    STAT+: Trump’s IVF deal spurs hopes — and adjustments — across fertility sector WASHINGTON — The Trump administration’s push to make in vitro fertilization more affordable is changing the outlook and offerings in the fertility sector, even as some details of its policies remain confidential and others have yet to be released. The administration’s changes…

  • Opinion: The U.S. experiment with profit-driven health care has failed

    Opinion: The U.S. experiment with profit-driven health care has failed Health care costs are surging. ACA Marketplace premiums will rise 18%  next year— even more for the millions set to lose their enhanced federal subsidies without congressional action. Meanwhile, big employers expect their premiums — already about $25,000 for family coverage — to increase 9%…

  • STAT+: Kaiser Permanente, DOJ nearing resolution in $1 billion Medicare fraud case

    STAT+: Kaiser Permanente, DOJ nearing resolution in $1 billion Medicare fraud case The Justice Department and Kaiser Permanente are nearing a deal in their behind-the-scenes negotiations over the government’s claim that the California health care giant bilked Medicare out of $1 billion.  The federal judge overseeing the DOJ’s long-running case against Kaiser on Friday granted…

  • Trump announces plan to expand fertility treatment coverage alongside latest pharma deal

    Trump announces plan to expand fertility treatment coverage alongside latest pharma deal The Trump administration has struck a deal with EMD Serono to lower drug prices — part of a larger push from the administration to expand coverage and improve affordability for fertility services, officials announced at the White House on Thursday. The administration’s plan…

  • STAT+: Medicare payments to doctors paused as government shutdown drags on

    STAT+: Medicare payments to doctors paused as government shutdown drags on The Centers for Medicare and Medicaid Services is pausing Medicare payments to doctors, as negotiations tied to the government shutdown drag on.  CMS announced the pause in a notice on its website but didn’t say when it would end. It’s happening because Congress needs…

  • STAT+: Medicare Advantage insurers still in retreat as annual enrollment kicks off

    STAT+: Medicare Advantage insurers still in retreat as annual enrollment kicks off Medicare Advantage has skyrocketed in popularity over the past decade, reeling in new members with zero-dollar premiums and generous benefits. But the rate of growth has slowed in recent years, and in 2026, there’s a decent chance enrollment will contract for the first…

  • STAT+: Top Democrat demands more detail from Medicare insurers about their use of AI

    STAT+: Top Democrat demands more detail from Medicare insurers about their use of AI Sen. Richard Blumenthal (D-Conn.) is pressing the nation’s largest Medicare Advantage insurers to provide more detail about their use of artificial intelligence tools amid reports that these companies are rapidly increasing their reliance on the technology to help make decisions about…

  • STAT+: Key GOP lawmaker tones down rhetoric on medical care for immigrants

    STAT+: Key GOP lawmaker tones down rhetoric on medical care for immigrants You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. Three cheers for Johns Hopkins epidemiologist Caitlin Rivers, who spent her Saturday…

  • STAT+: Who is winning the government shutdown?

    STAT+: Who is winning the government shutdown? You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. Thankfully, this year the saltwater cowboys of Virginia’s Eastern Shore rounded up wild ponies for their horsy…

  • STAT+: UnitedHealth taps Duke scientist to lead AI efforts

    STAT+: UnitedHealth taps Duke scientist to lead AI efforts UnitedHealth Group has tapped a Duke University artificial intelligence expert to be its chief AI scientist as the health care giant ramps up the use of the technology across its sprawling network of businesses, according to a memo obtained by STAT. Michael Pencina, chief data scientist…

  • Trump strikes deal with Pfizer aimed at lowering prescription drug prices

    Trump strikes deal with Pfizer aimed at lowering prescription drug prices WASHINGTON — President Trump announced on Tuesday that Pfizer has agreed to offer lower prices on its drugs to the Medicaid program and directly to patients, the first in what he said would be a series of deals intended to secure cheaper prescription medicines…

  • STAT+: Unsealed court documents reveal a whistleblower suit over UnitedHealth use of an artery disease test

    STAT+: Unsealed court documents reveal a whistleblower suit over UnitedHealth use of an artery disease test A law firm representing health care fraud whistleblowers is suing UnitedHealth Group over its use of a peripheral artery disease test, called QuantaFlo, to increase payments it received from the government Medicare program, after the Department of Justice declined…

  • STAT+: House GOP doesn’t include health insurance subsidies in stopgap government funding bill

    STAT+: House GOP doesn’t include health insurance subsidies in stopgap government funding bill WASHINGTON — House Republicans on Tuesday introduced a bill to fund the government at current levels until Nov. 21. It would include extensions of several health programs, but not the enhanced tax credits that have significantly lowered premiums for Affordable Care Act…

  • STAT+: CMS delays rule requiring Medicare Advantage insurers to remind members of unused benefits

    STAT+: CMS delays rule requiring Medicare Advantage insurers to remind members of unused benefits Medicare is delaying implementation of a Biden-era rule that would have made Medicare Advantage plans notify members about their unused supplemental benefits — services such as vision and dental.  Even though taxpayers hand health insurers more than $80 billion each year…

  • STAT+: Bipartisan bill to extend ACA tax credits offers hope for a deal

    STAT+: Bipartisan bill to extend ACA tax credits offers hope for a deal WASHINGTON — Republicans in the House and Senate are showing interest in extending the extra subsidies that help make Affordable Care Act health insurance plans cheaper, and that are set to expire at the end of this year. This week, Reps. Jen…

  • STAT+: How Trump may use Democrats’ drug-price negotiation law

    STAT+: How Trump may use Democrats’ drug-price negotiation law You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. I’m happy to report that Last Week Tonight with John Oliver did a segment on…

  • STAT+: Elevance loses lawsuit over Medicare Advantage quality ratings

    STAT+: Elevance loses lawsuit over Medicare Advantage quality ratings A federal judge in Texas struck down Elevance Health’s lawsuit that argued the government unfairly lowered its Medicare Advantage quality ratings — a decision that could cost Elevance $375 million in bonus revenue. U.S. District Judge Mark T. Pittman, appointed by President Trump in 2019, chastised…

  • STAT+: Prasad returns to the FDA, Attack on the CDC

    STAT+: Prasad returns to the FDA, Attack on the CDC You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. Normally I keep the intro to this newsletter light-hearted. But today I feel compelled…

  • STAT+: DOJ and UnitedHealth reach settlement on $3.3 billion Amedisys deal

    STAT+: DOJ and UnitedHealth reach settlement on $3.3 billion Amedisys deal The Department of Justice and state officials have reached a proposed settlement agreement with UnitedHealth Group and Amedisys that would allow the companies to complete their $3.3 billion combination so long as they agree to sell 164 home health and hospice locations across 19…

  • STAT+: Unpacking Trump’s approach to health care oversight

    STAT+: Unpacking Trump’s approach to health care oversight You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. I was reminded recently of why I dig mass transit upon overhearing the train conductor and…

  • STAT+: Preventive care panel could be restructured ‘imminently’ as RFK Jr. vets new members

    STAT+: Preventive care panel could be restructured ‘imminently’ as RFK Jr. vets new members WASHINGTON — Health secretary Robert F. Kennedy Jr. could “imminently” overhaul a key federal advisory panel that recommends which preventive services insurers must pay for, according to a person familiar with the plans.  The person said that federal health officials are…

  • STAT+: Hospitals boost their profit expectations for 2025 as health insurers stumble

    STAT+: Hospitals boost their profit expectations for 2025 as health insurers stumble Two major investor-owned hospital chains upped their 2025 revenue and profit forecasts this week, in stark contrast to health insurers, who’ve been doing the opposite.  HCA Healthcare and Tenet Healthcare, for-profit chains that collectively own 240 hospitals, both said their revenue and profit…