Dems look to extend ACA credits for 3 years | $1M lawsuit over surgical blade death | AI prior authorizations for Medicare

With the U.S. Senate passing a funding agreement to reopen the federal government, the House of Representatives will now have a chance to make changes—though there’s little chance this particular amendment will succeed.

The family of Jeffrey Alan Fulcher, 58, sued the Medical University of South Carolina after the father of three died six days after undergoing a minimally invasive procedure to remove part of his esophagus. The state, on behalf of the hospital, settled the case out of court. 

President Donald Trump’s administration argues that their “WISeR” model will eliminate unnecessary testing and save Medicare money. But eight Democrats opposing it think it will only bring Medicare Advantage chaos to Part A and Part B.

Starting in 2026, patients covered by UnitedHealthcare's Medicare Advantage and commercial plans will not have care reimbursed for instances of remote patient monitoring unless they have diagnosed heart failure or are pregnant and experiencing hypertension. The shift stands at odds with traditional Medicare, which added new claims codes for providers to use next year.

President Donald Trump’s administration wants states to check to see if hundreds of thousands of residents are enrolled in Medicaid illegally. CMS provided a specific list of people it suspects are undocumented.

The ransomware attack on Integris Health, a nonprofit health system in Oklahoma, happened in late 2023. Victims of the breach said they were extorted by hackers directly.

Physician-founded Counsel Health said it will use the funds to hire more doctors as it expands the userbase for its AI, which allows patients to ask questions and get answers from a real doctor.

SCAI President Srihari Naidu, MD, detailed some of the challenges interventional cardiologists face as reimbursements keep declining. The group has been building new partnerships with other medical societies to strengthen its influence in Washington. 

Although the drug can slow the progression of cognitive decline, it may have little impact on damage already done by AD prior to treatment.