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News You Need to Know Today
Medicare Advantage regulation proposed | Lawsuit challenges state abortion protections | Uninsured stroke patient denied care
Monday, July 28, 2025
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Today's News and Trends

House bill aims to bring parity to Medicare reimbursement

The Prompt and Fair Pay Act would require Medicare Advantage insurers to reimburse providers at traditional Medicare rates, effectively closing the payment gap between public and private plans.

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prior authorization claim deny denial insurance insurer payer Medicare Advantage
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House bill aims to bring parity to Medicare reimbursement

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prior authorization claim deny denial insurance insurer payer Medicare Advantage
The Prompt and Fair Pay Act would require Medicare Advantage insurers to reimburse providers at traditional Medicare rates, effectively closing the payment gap between public and private plans.
READ MORE >

Federal lawsuit in Texas marks first wrongful death case involving interstate abortion

A conservative lawyer is using the Comstock Act of 1873, which bans the mailing of obscene materials, to challenge the practice of sending abortion pills to states that have passed bans. 

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abortion law ban pregnancy dobbs
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Federal lawsuit in Texas marks first wrongful death case involving interstate abortion

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abortion law ban pregnancy dobbs
A conservative lawyer is using the Comstock Act of 1873, which bans the mailing of obscene materials, to challenge the practice of sending abortion pills to states that have passed bans. 
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Uninsured stroke patient sues Maine Med over alleged denial of emergency care

Jamaica resident Edwin George Duffus, 65, claims the hospital discharged him after learning he didn’t have medical coverage. A federal court ruled his lawsuit can move forward.

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Denied
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Uninsured stroke patient sues Maine Med over alleged denial of emergency care

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Denied
Jamaica resident Edwin George Duffus, 65, claims the hospital discharged him after learning he didn’t have medical coverage. A federal court ruled his lawsuit can move forward.
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Featured Articles

VA redirects $800M to upgrade EHR systems, infrastructure

The Department of Veterans Affairs said the new funding was made possible by its cost-saving measures, including a reduction of 30,000 staff and the consolidation of call centers.

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VA redirects $800M to upgrade EHR systems, infrastructure

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The Department of Veterans Affairs said the new funding was made possible by its cost-saving measures, including a reduction of 30,000 staff and the consolidation of call centers.
READ MORE >

Grisly tales emerge from investigation into high demand for human organs

A New York Times investigation revealed multiple incidents where patients were prepped for organ procurement while still alive, raising concerns about the influence of donation organizations.

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Grisly tales emerge from investigation into high demand for human organs

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A New York Times investigation revealed multiple incidents where patients were prepped for organ procurement while still alive, raising concerns about the influence of donation organizations.
READ MORE >

DOJ investigation of UnitedHealth confirmed in SEC filing

The company said in a Securities and Exchange Commission filing that it is cooperating with the Department of Justice’s inquiry into possible incidents of Medicare Advantage upcoding.

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UnitedHealthcare HQ Sign
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DOJ investigation of UnitedHealth confirmed in SEC filing

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UnitedHealthcare HQ Sign
The company said in a Securities and Exchange Commission filing that it is cooperating with the Department of Justice’s inquiry into possible incidents of Medicare Advantage upcoding.
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In Case You Missed It

AMA trustee says the U.S. healthcare system is in a state of crisis

“We are in a crisis with healthcare research, administrative burdens, and with payment. Access for our patients is hurt," said American Medical Association (AMA) Board of Trustees member Scott Ferguson, MD, FACR.

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American Medical Association (AMA) Board of Trustees member Scott Ferguson, MD, FACR, a diagnostic radiologist in West Memphis, Arkansas, explains the combination of new healthcare policies under the Trump Administration are and problems that already existed under other administrations that were never fully addressed, are accelerating what the AMA sees as a growing crisis.
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AMA trustee says the U.S. healthcare system is in a state of crisis

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American Medical Association (AMA) Board of Trustees member Scott Ferguson, MD, FACR, a diagnostic radiologist in West Memphis, Arkansas, explains the combination of new healthcare policies under the Trump Administration are and problems that already existed under other administrations that were never fully addressed, are accelerating what the AMA sees as a growing crisis.
“We are in a crisis with healthcare research, administrative burdens, and with payment. Access for our patients is hurt," said American Medical Association (AMA) Board of Trustees member Scott Ferguson, MD, FACR.
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HHS, RFK sued by medical associations over COVID policy shift

Multiple professional groups, including the American Academy of Pediatrics and the American College of Physicians, challenge recent policy changes to vaccine recommendations for COVID-19, which end routine inoculations for minors and pregnant women.

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U.S. Department of Health and Human Services (HHS) sign.
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HHS, RFK sued by medical associations over COVID policy shift

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U.S. Department of Health and Human Services (HHS) sign.
Multiple professional groups, including the American Academy of Pediatrics and the American College of Physicians, challenge recent policy changes to vaccine recommendations for COVID-19, which end routine inoculations for minors and pregnant women.
READ MORE >

What’s in the ‘Big, Beautiful Bill’—and what was left out?

Sweeping tax cuts and reduced spending on Medicaid and SNAP were signed into law by President Donald Trump. However, a key provision that would have paused new AI regulations was removed by the Senate.

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Trump and Robert F. Kennedy Jr., secretary of health and human services (HHS). White House press photo
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What’s in the ‘Big, Beautiful Bill’—and what was left out?

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Trump and Robert F. Kennedy Jr., secretary of health and human services (HHS). White House press photo
Sweeping tax cuts and reduced spending on Medicaid and SNAP were signed into law by President Donald Trump. However, a key provision that would have paused new AI regulations was removed by the Senate.
READ MORE >

In Other News

Society of Interventional Radiology opposes value-based care proposal

Under the proposal, Medicare would add an interventional radiology payment pathway, creating a new reporting framework for IRs as part of MIPS.

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Society of Interventional Radiology opposes value-based care proposal

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Under the proposal, Medicare would add an interventional radiology payment pathway, creating a new reporting framework for IRs as part of MIPS.
READ MORE >

Edwards Lifesciences loses TAVR leader to robotics firm, announces replacement

The change comes at a momentous time for the company's TAVR portfolio, which made history in May by receiving the very first FDA approval for treating asymptomatic severe AS.

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Larry Wood
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Edwards Lifesciences loses TAVR leader to robotics firm, announces replacement

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Larry Wood
The change comes at a momentous time for the company's TAVR portfolio, which made history in May by receiving the very first FDA approval for treating asymptomatic severe AS.
READ MORE >

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