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Trump’s ‘Great Healthcare Plan’ | UnitedHealth’s rural Medicare Advantage pilot | Kaiser settles fraud case for $556M

News You Need to Know Today
Trump’s ‘Great Healthcare Plan’ | UnitedHealth’s rural Medicare Advantage pilot | Kaiser settles fraud case for $556M
Friday, January 16, 2026
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Today's News and Trends

In brief: Trump’s ‘Great Healthcare Plan’ | Nat’l healthcare spending | Working families and healthcare affordability

President Trump’s outline is largely an exercise in thinking out loud since it can’t propel anything consequential without legislative action in Congress. Still, the plan—and the reactions it’s eliciting—warrant a look. 

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Trump Great Healthcare Plan
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In brief: Trump’s ‘Great Healthcare Plan’ | Nat’l healthcare spending | Working families and healthcare affordability

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Trump Great Healthcare Plan
President Trump’s outline is largely an exercise in thinking out loud since it can’t propel anything consequential without legislative action in Congress. Still, the plan—and the reactions it’s eliciting—warrant a look. 
READ MORE >

UnitedHealthcare launches rural Medicare Advantage pilot to cut reimbursement delays 50%

The insurer is planning to reduce reimbursement timelines for hospitals in Oklahoma, Idaho, Minnesota and Missouri from 30 days to 15. The details are unclear, but the company said the framework could extend nationwide.

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UnitedHealthcare HQ Sign
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UnitedHealthcare launches rural Medicare Advantage pilot to cut reimbursement delays 50%

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UnitedHealthcare HQ Sign
The insurer is planning to reduce reimbursement timelines for hospitals in Oklahoma, Idaho, Minnesota and Missouri from 30 days to 15. The details are unclear, but the company said the framework could extend nationwide.
READ MORE >

Kaiser Permanente hit with record-setting $556M Medicare Advantage fraud settlement

The California-based health system faced multiple accusations of upcoding diagnoses to receive additional risk-adjusted payments from the Medicare Advantage program. Its payer plan and providers were implicated in what the DOJ described as systemic fraud. Kaiser Permanente denies any wrongdoing.

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the-kaiser-permanente-thrive-center-street-telegraph_1300x867.jpg
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Kaiser Permanente hit with record-setting $556M Medicare Advantage fraud settlement

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the-kaiser-permanente-thrive-center-street-telegraph_1300x867.jpg
The California-based health system faced multiple accusations of upcoding diagnoses to receive additional risk-adjusted payments from the Medicare Advantage program. Its payer plan and providers were implicated in what the DOJ described as systemic fraud. Kaiser Permanente denies any wrongdoing.
READ MORE >

Featured Articles

AI roundup: Of workslop and rework | Patent that tech, industry player | Artificial Intellectualism, anyone?

Across industries, more than a third of the time saved by AI gets eaten by overstretched humans who have to clean up the technology’s sloppy work. 

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AI workslop rework
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AI roundup: Of workslop and rework | Patent that tech, industry player | Artificial Intellectualism, anyone?

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AI workslop rework
Across industries, more than a third of the time saved by AI gets eaten by overstretched humans who have to clean up the technology’s sloppy work. 
READ MORE >

HHS reinstates hundreds of CDC workers fired by DOGE

The rehired workers were all part of the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health (NIOSH). A union representing federal workers confirmed the reinstatements, and the Department of Health and Human Services has already sent emails to affected staff. 

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U.S. Department of Health and Human Services (HHS) sign.
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HHS reinstates hundreds of CDC workers fired by DOGE

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U.S. Department of Health and Human Services (HHS) sign.
The rehired workers were all part of the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health (NIOSH). A union representing federal workers confirmed the reinstatements, and the Department of Health and Human Services has already sent emails to affected staff. 
READ MORE >

Rural hospitals face equipment uptime challenges—here's how to overcome them

Rural hospitals face greater challenges than their metropolitan counterparts in keeping medical equipment operational, because there's rarely a vendor technician around when they need one. 

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Chris Espinosa, CBET, a biomedical engineer and regional service manager from InterMed, outlines some of the issues facing rural hospitals and why they can have longer downtime for equipment than larger metropolitan area hospitals.
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Rural hospitals face equipment uptime challenges—here's how to overcome them

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Chris Espinosa, CBET, a biomedical engineer and regional service manager from InterMed, outlines some of the issues facing rural hospitals and why they can have longer downtime for equipment than larger metropolitan area hospitals.
Rural hospitals face greater challenges than their metropolitan counterparts in keeping medical equipment operational, because there's rarely a vendor technician around when they need one. 
READ MORE >

Cash prices frequently undercut insurance rates at Texas hospitals, study finds

Research from healthcare data analytics firm Trilliant Health found that negotiated rates carry a higher price tag for common services, calling into question the value of transparency regulations.

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scale money prices shopping transparency reimbursement dollar coins
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Cash prices frequently undercut insurance rates at Texas hospitals, study finds

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scale money prices shopping transparency reimbursement dollar coins
Research from healthcare data analytics firm Trilliant Health found that negotiated rates carry a higher price tag for common services, calling into question the value of transparency regulations.
READ MORE >

In Case You Missed It

Hospitals providing organs to wealthy international patients, leaving Americans waiting

A new report from the New York Times reveals a system of de facto quid pro quo where wealthy patients from oil-rich nations are sometimes moved to the top of organ transplant lists.

READ MORE >
Stock image of an illegal bribe.
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Hospitals providing organs to wealthy international patients, leaving Americans waiting

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Stock image of an illegal bribe.
A new report from the New York Times reveals a system of de facto quid pro quo where wealthy patients from oil-rich nations are sometimes moved to the top of organ transplant lists.
READ MORE >

Cyberattack on member-owned healthcare payer ends in $3.5M settlement

The January 2024 incident at Group Health Cooperative of South Central Wisconsin had all of the hallmarks of a ransomware attack, with an unknown cybercrime group taking credit in a letter to the payer. In total, 533,000 people were impacted by the data breach.

READ MORE >
cybersecurity hacker ransomware cyber data breach
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Cyberattack on member-owned healthcare payer ends in $3.5M settlement

Share on Twitter Share on Facebook Share on Linkedin
cybersecurity hacker ransomware cyber data breach
The January 2024 incident at Group Health Cooperative of South Central Wisconsin had all of the hallmarks of a ransomware attack, with an unknown cybercrime group taking credit in a letter to the payer. In total, 533,000 people were impacted by the data breach.
READ MORE >

In Other News

FDA clears opportunistic AI for detecting cardiothoracic issues in CT scans

“Coronary calcium revealed long ago that atherosclerosis begins well before symptoms. AI-CVD extends that insight by enabling systematic identification of patients who are unaware of their cardiovascular risk using CT scans that already exist,” said Arthur Agatston, MD.

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The U.S. Food and Drug Administration (FDA) has cleared HeartLung Corporation's AI-CVD, an artificial intelligence (AI) algorithm that looks at 11 different opportunistic health screening assessments on chest CT exams ordered for any reason.
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FDA clears opportunistic AI for detecting cardiothoracic issues in CT scans

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The U.S. Food and Drug Administration (FDA) has cleared HeartLung Corporation's AI-CVD, an artificial intelligence (AI) algorithm that looks at 11 different opportunistic health screening assessments on chest CT exams ordered for any reason.
“Coronary calcium revealed long ago that atherosclerosis begins well before symptoms. AI-CVD extends that insight by enabling systematic identification of patients who are unaware of their cardiovascular risk using CT scans that already exist,” said Arthur Agatston, MD.
READ MORE >

Medicare payment advisors urge Congress to increase radiologist reimbursement

MedPAC, an independent panel of experts that advises lawmakers on payment policy, is endorsing an additional 0.5% update to doc pay, the AMA reports.  

READ MORE >
Medicare money bills dollars
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Medicare payment advisors urge Congress to increase radiologist reimbursement

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Medicare money bills dollars
MedPAC, an independent panel of experts that advises lawmakers on payment policy, is endorsing an additional 0.5% update to doc pay, the AMA reports.  
READ MORE >

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