Bipartisan Bill Seeks to Strengthen Oversight of Medicare Advantage
Lawmakers introduced the Medicare Advantage Improvement Act of 2026 to tighten prior authorization rules, boost transparency and curb practices that delay care.
What Did Lawmakers Discuss at the House Hearing on Health AI?
Lawmakers and health experts convened on Capitol Hill this week to discuss the use of AI in healthcare. They highlighted the technology’s potential to reduce administrative burdens and boost care access in rural areas — while also warning about oversight gaps and the risks of AI-driven prior authorization.
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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.
Congressman Launches Investigation into Medicaid Prior Authorization Denials
U.S. Representative Frank Pallone, Jr. (D-New Jersey) announced that he is looking into high prior authorization denial rates by Medicaid managed care health plans. It follows a report by the Office of Inspector General that found that Medicaid MCOs denied one out of every eight prior authorization requests in 2019.
House Reps Introduce Bill To Ease State Medicaid Staffing Shortages Amid Redeterminations
The Medicaid Staffing Flexibility and Protection Act was introduced by Representative Earl L. “Buddy” Carter (R-Georgia) and Representative Neal Dunn (R-Florida). It would allow state Medicaid agencies to hire outside contractors to help with Medicaid redeterminations, as many agencies don’t have the workforce to handle the return to the redetermination process.
Bipartisan Legislation Efforts Build Against PBMs
A bipartisan group of House representatives introduced the Drug Price Transparency in Medicaid Act on Friday. The bill would ban spread pricing in Medicaid programs.
Bill mandating electronic prior authorizations may not improve care quality
The Act, along with mandating the adoption of electronic prior authorization, requires greater levels of transparency, approval rates, and rationale for denied requests.
Beyond Analytics: How Sellers Dorsey is Hard-Coding Value into Medicaid Policy [Video]
How to turn analytics into actual policy outcomes.
House passes bill that would require CMS to negotiate some drug prices
The House voted 230-192, mostly along party lines, for the Elijah E. Cummings Lower Drug Costs Now Act. The Trump administration has indicated it would veto the bill and stated that it would harm innovation.
Congressman calls for criminal investigation of Cohen over Novartis relationship
In testimony Wednesday, former Trump attorney Michael Cohen testified he had spoken to Novartis six times. Rep. Mark Meadows issued a referral for criminal investigation over contacts with Novartis and Kazakhstan's BTA Bank.
Right-to-try bill passes in House, heads to president’s desk for signature
The legislation, which has drawn criticism from researchers, patient advocates and industry, would enable patients to request experimental drugs while bypassing the FDA.
House passes ACA replacement in 217-213 vote
The votes are in, and the House has narrowly passed the AHCA, the GOP's plan to repeal and replace the ACA. Next stop? The Senate.
The Power Behind Enterprise EHR Software for Large Healthcare Systems
Enterprise EHR boosts scalability, interoperability, and governance for large healthcare systems.
Soul-crushing regulations: How bureaucrats are chasing smart young entrepreneurs out of HIT
At the House Energy and Commerce Committee’s second roundtable on digital health, Jonathan Bush spoke up for the people who were not in the room. He and several of 10 panelists explained that the culture of “wanton, random, soul-crushing regulation” was scaring many entrepreneurs and millions of VC dollars away from healthcare. He had two […]