Plus, CMS turns up heat on MA audits
 

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New Mountain Capital brings together 3 companies to form AI-enabled RCM platform

A new company, called Smarter Technologies, launched today, combining three health tech companies backed by New Mountain Capital—Access Healthcare, Thoughtful.ai and SmarterDx.
 

Top Stories

Will Trump's tax bill cut Medicare by $490B? Not exactly

The Congressional Budget Office correctly stated Trump's tax bill would force cuts to Medicare. Budget analysts are tempering concerns, as the relevant provision is expected to be waived as in prior years.

CMS deploying more coders, 'advanced systems' to audit all Medicare Advantage contracts

Mehmet Oz, M.D., is cracking down on Medicare Advantage in the latest effort to root out waste, fraud and abuse.

Trump budget bill would modernize HSAs, incentivize shift to rebranded ICHRAs

Individuals would find it easier to access benefits from health savings accounts, direct primary care arrangements and ICHRA plans, if the current budget bill rolling through Congress is signed into law.

How the Medicaid reconciliation bill could help wither away the Affordable Care Act

With most eyes on Medicaid cuts in Congress, keep a close eye on impacts to ACA enrollment over the next six months, warn health policy experts.

House GOP advances budget megabill, imposing stricter Medicaid work requirements

The latest version of the bill would see work requirements imposed sooner and changes to state-directed payments, cost-sharing reductions, eligibility checks and gender-affirming care.

New Evernorth program to cap out-of-pocket costs for Wegovy, Zepbound at $200

Cigna's Evernorth is rolling out a new pharmacy benefit management program that caps members' monthly cost for key GLP-1 drugs.

Catholic health systems warn of program closures, higher premiums if Medicaid cuts pass

In a briefing held by the Catholic Health Association, hospital leaders referred to the “moral imperative” they and Congress share to preserve the country’s safety net. 

MAHA report blames 'overmedicalization,' pharma's influence for children's poor health

Misdiagnoses, vaccine safety reporting and drugmakers' "corporate capture" earned substantial ink in a hotly anticipated report from the White House's Make America Healthy Again Commission, chaired by Department of Health and Human Services Secretary Robert F. Kennedy Jr.

Kettering Health suffers systemwide tech outage from cyberattack, cancels elective procedures

A cyberattack is causing a systemwide technology outage at Kettering Health and its network of more than a dozen medical centers in Ohio.
 
Fierce podcasts

Don’t miss an episode

A pulse check on AI adoption in healthcare

Despite all the AI hype, most healthcare organizations are stuck in pilot mode. This week on "Podnosis," Fierce Healthcare Executive Editor Heather Landi explores why so few projects scale and what moving from promise to progress will take.
 

Resources

Whitepaper

Social Care Data: Leveraging Standards for CBO Reimbursement

Discover how standardized social care data from CBO partners streamlines reimbursement processes and supports value-based care. Understand the coding frameworks that enable payment for essential social care services and how Findhelp facilitates effective CBO integration.
eBook

Cut Costs. Boost Care. Get Smart with Benefits.

Healthcare costs are soaring — but leading employers aren’t just watching. They're using data to take control. Discover how advanced analytics can unify your benefits, reveal savings, and drive better care in our latest report.
 

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