MedCity News

Providers, Policy, Payers, Legal

Appeals Court Sides with Providers in No Surprises Act Pay Dispute

By Katie Adams

Payers, Health Tech

Cotiviti Launches AI Solution to Address Coordination of Benefits Issues

Cotiviti launched an AI-powered coordination of benefits solution that uses enrollment data to identify and resolve coverage issues before claims are submitted.

By Marissa Plescia

BioPharma, Legal

PTC Therapeutics’ $211M Bid Wins Bankruptcy Auction for Sangamo Gene Therapy

Sangamo Therapeutics filed for Chapter 11 bankruptcy in June after its search for strategic alternatives failed to find a path forward for the company. PTC Therapeutics’ auction win brings a Sangamo gene therapy candidate for Fabry disease, a rare inherited disorder with few treatment options.

By Frank Vinluan

MedCity Influencers

Founders Should Stop Worrying If They’re “AI Enough”

In healthcare, enterprises are moving slower than the hype cycle would lead you to believe. That said, they’re not moving slowly – they are saying yes to AI, as long as it can solve for specific workflow needs.

By Blake Walker

Latest Video

Latest News

Artificial Intelligence, Startups, Health Tech, Providers

New Startup Launches to Close the Bedside Communication Gap in Hospitals

The 1842 Fund launched a new startup called Suvi Health, which is developing an ambient AI platform that records hospital bedside conversations and turns them into a shared task list for patients and families. The company will pilot the tool with Mayo Clinic starting next month.

By Katie Adams

Consumer / Employer

Report: Employers’ Use of Big Three PBMs Falls in 2026

A new survey finds that employers are moving away from the Big Three PBMs while prioritizing healthcare affordability and transparency.

By Marissa Plescia

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Inside an Automated Healthcare Practice: Redesigning Care Around People, Not Paperwork 

By reducing administrative burden and redesigning workflows around human needs, it creates space for what matters most: connection between clinicians and patients.

By Michael Blackman, MD, MBA Chief Medical Officer, Greenway Health®

BioPharma, Startups

Startup Boulevard Bio Launches With Immune Reset Pioneer Schett as Co-Founder

Deerfield Management formed Boulevard Bio with scientific co-founders Georg Schett and Frank Nestle. The startup’s lead program is in early clinical development for an autoimmune kidney disorder, and could offer dosing advantages over a recently approved Vera Therapeutics medicine and a Vertex Pharmaceuticals drug currently under FDA review.

By Frank Vinluan

MedCity Influencers

Ambulatory Growth Demands a New Operating Model

While organizations have invested heavily in expanding ambulatory networks, many are discovering that operational workflows have not evolved at the same pace. The result is a growing gap between demand and the systems designed to manage it.

By Michelle Skinner

Health Tech, Providers

Health IT Vendor’s Data Breach Exposes Nearly 4M Patient Records

Revenue cycle vendor Unlimited Technology Systems disclosed a ransomware attack affecting 3.8 million patients — the second-largest healthcare data breach reported to HHS this year.

By Katie Adams

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Sponsored Post

From Blind Spots to Better Outcomes: How SNF Data Transparency Strengthens LTSS

What if health plans could identify member decline before an avoidable hospitalization occurs? Real-time clinical visibility into long-stay SNF members uncovers risk earlier and drives better outcomes.

By Anna Keith, Vice President of LTSS Product & Strategy at Centene Corporation, and Phyllis Wojtusik, RN, Executive Vice President of Value-Based Care at Real Time Medical Systems

Health Tech

NOCD Announces Plans for National Expansion of Intensive Outpatient Therapy

NOCD, a virtual provider for OCD, announced plans to expand its virtual intensive outpatient program for people with severe OCD nationwide.

By Marissa Plescia

BioPharma, Pharma

Infinimmune Secures $75M for a More Human Approach to Developing Better Antibody Drugs

Immunology startup Infinimmune is developing antibody drugs with potential advantages over traditional monoclonal antibodies. The Series A financing will support two lead programs entering the clinic in atopic dermatitis.

By Frank Vinluan

presented by

Sponsored Post

Closing the Quality-Affordability Gap in Workplace Mental Health

In an interview, Kyan Health Co-Founder and Chief Commercial Officer Konstantin Struck discussed how Kyan gives mid-market and enterprise employers access to premium workforce mental healthcare, at a price point that is affordable.

By Stephanie Baum

MedCity Influencers

From Friction to Fix: Measuring What’s Breaking Payer-Provider Trust

Tolerance for this abrasion is gone. It wastes time, drains staff capacity, drives up costs, and affects the patient experience.

By Russ Thomas

Sponsored Post

Which Health Tech Companies Are Getting Customer Experience Right?

A new report from Forrester offers a score card assessing health tech vendors on customer experience for healthcare organizations considering adopting them.

By League and MedCity News

Devices & Diagnostics, Startups, Health Tech

How CMS Is Tackling ‘Coverage Purgatory’ for Medical Devices

CMS unveiled new details of its new RAPID pathway, which is designed to close the gap between FDA approval and Medicare coverage for breakthrough medical devices. Industry reaction has been largely positive, as medical device companies often sit in “coverage purgatory” for years.

By Katie Adams

Payers, BioPharma

Amazon Pharmacy Executive: Formularies are Anti-Choice

Tanvi Patel, vice president and general manager of Amazon Pharmacy, and her co-panelists at the recent Bullseye event, explained why PBMs, payers and doctors are all hampering consumer choice when it comes to patients getting affordable drugs.

By Arundhati Parmar

Consumer / Employer, Payers

Small Businesses Could Face Double-Digit Premium Hikes in 2027

Small group insurers are proposing a median 14% premium increase for 2027, driven by rising healthcare costs.

By Marissa Plescia

BioPharma, Startups, Pharma

Jazz Pharma Expands Again in Epilepsy With $820M Actio Bio Acquisition

Jazz Pharmaceuticals, maker of the blockbuster epilepsy drug Epidiolex, is acquiring Actio Biosciences and its lead drug in pivotal testing for a rare type of epilepsy with no FDA-approved treatments. It’s Jazz’s second epilepsy deal in the past year.

By Frank Vinluan

Payers, Artificial Intelligence

MedCity Pivot: How Aetna is Adopting Agentic AI

In this episode of the MedCity Pivot Podcast, CVS Health Aetna's chief digital and technology officer talks about how the insurance business is using AI, especially agentic AI, in healthcare. Point to note: AI is not used in automatic denials of coverage.

By Arundhati Parmar

MedCity Influencers

AI in Drug Development is Not a Data Problem — It’s An Evidence Problem

Drug development isn't limited by the amount of data we collect, but by our ability to preserve the context, meaning and relationships that transform data into evidence.

By Narasimha Kumar