Regulatory & Legislative Updates

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

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.
A Once-Daily Epilepsy Pill With No Titration Clears Phase 3

A Once-Daily Epilepsy Pill With No Titration Clears Phase 3

Sonia Reyes
Specialty Medicine, Neurology & CNS Disorders, Regulatory & Legislative Updates | Apr 23, 2026
Azetukalner, a once-daily oral antiseizure agent requiring no titration, reduced focal onset seizures by 53% in phase 3 X-TOLE2, with an NDA filing expected mid-2026
Insurer Claims of Prior Authorization Cutbacks Draw Skepticism From Physicians and Policy Experts

Insurer Claims of Prior Authorization Cutbacks Draw Skepticism From Physicians and Policy Experts

George Padron
Prior Authorization & Appeals, Medicare/Medicaid Updates, Coverage Navigation Strategies, Appeals & Denials Management, Reimbursement Changes, Practice Management, Regulatory & Legislative Updates | Apr 13, 2026
AHIP says insurers eliminated 6.5M prior authorizations for medical services, but critics call the announcement vague and say prescription drugs were excluded.
Medicare's AI-Driven Prior Authorization Pilot Draws Physician Backlash and a Federal Lawsuit

Medicare's AI-Driven Prior Authorization Pilot Draws Physician Backlash and a Federal Lawsuit

Sonia Reyes
Prior Authorization & Appeals, State & Federal Regulations, Medicare/Medicaid Updates, Healthcare Headlines, Policy & Legislation, Reimbursement Changes, Practice Management, Regulatory & Legislative Updates | Apr 10, 2026
Three months into Medicare's WISeR prior auth pilot, physicians report widespread claim denials, and the EFF has sued CMS for transparency on AI vendor practices.
White-Label Medical Groups Face Regulatory Scrutiny in GLP-1 Telehealth Crackdown

White-Label Medical Groups Face Regulatory Scrutiny in GLP-1 Telehealth Crackdown

George Padron
Policy & Legislation, Public Health Initiatives, Regulatory & Legislative Updates | Mar 13, 2026
A STAT News investigation finds that four medical groups are linked to 30% of FDA-warned GLP-1 telehealth companies, raising legal and patient safety concerns for payers.
When the Brain Leads, Regulators (Slowly) Follow

When the Brain Leads, Regulators (Slowly) Follow

Sonia Reyes
Policy & Legislation, Regulatory & Legislative Updates | Feb 26, 2026
Brain-computer interface startups face a regulatory impasse: the FDA requires proof of patient benefit, but the field has yet to agree on how to measure it.
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