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Medicare Will Start Paying AI Companies a Share of Any Claims They Automatically Reject

It's long been the practice of private health insurers to require "prior authorization" before you can get the treatment you need. Often, they'll try to deny as many of these claims as possible — including with the use of AI models. Government-backed plans like Medicare, however, have tended to cover what private insurers don't, and without the laborious application process. But that could be poised to change. The Centers for Medicare and Medicaid Services said it'll experiment with its own ve

Feds Launch Experiment to Have Medicare Cover GLP-1 Weight Loss Drugs

The federal government may not have closed the window on paying for GLP-1 weight loss drugs like Ozempic and Zepbound after all. The Trump administration is reportedly planning to conduct an experiment that will allow some people to have obesity drugs covered by their Medicaid and Medicare plans. The Washington Post first broke the news Friday morning, having reportedly obtained documents from the Centers for Medicare and Medicaid Services outlining the plan. It would enable state Medicaid prog

UnitedHealth Group Says It Is Cooperating With a DOJ Investigation

UnitedHealth Group, the company that owns healthcare conglomerate UnitedHealth, said on Thursday that it is cooperating with the federal government as it fields criminal and civil requests from authorities. The company announced its cooperation with the feds in a statement published to its website on Thursday. “UnitedHealth Group (the “Company”) proactively reached out to the Department of Justice after reviewing media reports about investigations into certain aspects of the Company’s participa

UnitedHealth says it is facing DOJ investigation over Medicare billing practices

UnitedHealth Group revealed Thursday it is facing a Department of Justice investigation over its Medicare billing practices, adding to a string of setbacks for a company that owns the nation's largest and most powerful private insurer. In a securities filing, the company said it has started complying with formal criminal and civil requests from the DOJ, and that it reached out to the department after reports of the probes surfaced. UnitedHealth also said it has launched a third-party review of

Bandages made of medical waste cost Medicare $10B last year—limits are coming

Last year, Medicare spent over $10 billion on dubious bandages—called skin substitutes—that come with eye-popping prices. Some are made from medical waste, like dried bits of discarded placentas or infant foreskin, and many have not gone through rigorous testing to prove they offer any advantage over standard bandages. Yet, in some cases, Medicare reportedly paid for bandages priced at more than $21,000 per square inch. And individual patients have quickly racked up bills over $1 million just fo