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

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. 

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.

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.

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. 

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. 

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. 

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.

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.

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.

“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.

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.