Lawrence Wilson

By adding diagnoses to a patient’s risk analysis that no doctor had ever indicated, an insurance company can ...

Proposed payment rules for 2027 will prioritize accountable care organizations, rewarding physicians for maintaining patient wellness.

A handful of large corporations now control medication availability, pricing, and payment for the vast majority of Americans.

A new proposed rule would cut Medicare reimbursement by 40 percent on prescription drugs for providers who already ...

The findings are based on a study of early rate requests by Obamacare insurers in 16 states.

Lawmakers have urged Robert F. Kennedy Jr. to end the dispute between Eli Lilly and major hospital systems ...

The new budget provision levies a fee on companies with 50 or more full-timers receiving Medicaid benefits.

Florida tightens pharmacy benefit managers rules. Iowa bars insurer interference in physician referrals and restricts insurer pre-approval denials.

Enrollment peaked at 22.1 million last year and dropped to 19.2 million as of February, according to federal ...

Americans should never have to wonder whether a procedure was done out of medical necessity or for profit, ...

The administration notified more than 500 hospitals that they are not in compliance with federal rules on price ...

The drugmaker is demanding claims data, alleging some hospitals are double-dipping on federal discounts.

A major survey on affordability shows rising coverage denial rates and increased anxiety about coverage and cost.

The announcement was made one month after similar measures were taken in California.

A conservative think tank estimates 6.2 million improper enrollments in 2026. That's more than one-quarter of all enrollments.

The number of drugs available on the clearinghouse site for direct consumer purchase is now more than 750.

Americans declared their freedom in 1776 and ratified it in 1788. They're still arguing about what it means.

How pharmaceutical companies use the patent system to delay generic drugs from coming to market.

Patients without extra financial help paid nearly 40 percent more in out-of-pocket costs in vertically integrated plans, the ...

How pharmaceutical companies use the patent system to delay generic drugs from coming to market.

Hospitals are subject to an administrative equity penalty if they continue referring to out-of-network providers.

The clearinghouse website will also offer comparison shopping and click-through options to home-delivery pharmacies.

The decision likely ends legal challenges to the program, which was created in 2022 and began reducing prices ...

The action was part of a nationwide crackdown on fraud, waste, and abuse in the Medicare and Medicaid ...

The action is the latest in a series of steps to crack down on fraud in Medicare services ...

Trump endorsed GOP challengers in seven state Senate races where incumbents had opposed a congressional redistricting bid backed ...

Best known for its role in the American Revolution, the Christ Church of Boston's North End neighborhood is ...