Medicare/Medicaid Updates

Medicare Advantage's AI Era Calls for New Accountability, Columbia Law Review Note Argues

George Padron
AI & Critical Decision Support, Prior Authorization & Appeals, Medicare/Medicaid Updates, Appeals & Denials Management, Reimbursement Changes | May 6, 2026
Emma Ziegler's note in the Columbia Law Review uses real cases to argue Medicare Advantage AI denials need stronger CMS transparency rules and accessible appeals.

CMS Asks Every State to Re-Examine High-Risk Medicaid Providers

Sonia Reyes
Medicare/Medicaid Updates, Healthcare Headlines, Regulatory & Legislative Updates | Apr 30, 2026
CMS Administrator Oz directs every state to revalidate high-risk Medicaid providers, with governors notified by May 7 and full plans due within 30 days.

Uninsured Rate Climbs for First Time in Five Years as Medicaid Unwinding Disrupts Coverage

George Padron
Medicare/Medicaid Updates, Healthcare Headlines | Apr 28, 2026
A KFF brief finds U.S. uninsured rates rose in 2024 for the first time since 2019, as Medicaid unwinding outpaced ACA Marketplace gains, affecting 26.7 million people.

Oldest Baby Boomers Reach 80, Driving Demand for Better Managed Care Models and Aging Services

George Padron
Medicare/Medicaid Updates, Healthcare Headlines | Apr 27, 2026
As baby boomers reach 80, their healthcare spending, political influence, and expectations are reshaping aging services and managed care priorities.

CMS Health Tech Ecosystem Launches Initial Tools to Modernize Data Sharing for Plans and Patients

Sonia Reyes
AI & Critical Decision Support, State & Federal Regulations, Medicare/Medicaid Updates, Health Information Exchange, Care Coordination | Apr 24, 2026
CMS debuts health tech tools including Humana data integration and QR-based record sharing as part of its voluntary interoperability ecosystem initiative.