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News You Need to Know Today
UnitedHealthcare eliminated prior authorizations for 2,000 pediatric codes | CVS Health to spin off its pharmacy business
Thursday, November 5, 2026
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Today's News and Trends

UnitedHealthcare eliminates prior authorizations for 2,000 pediatric procedures

The list includes diagnostics and common care associated with oncology, orthopedics and ENT care for patients under the age of 18. The company framed the change as a part of its ongoing commitment to eliminate 30% of all pre-care reimbursement approvals by 2027.

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Pediatrics
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UnitedHealthcare eliminates prior authorizations for 2,000 pediatric procedures

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Pediatrics
The list includes diagnostics and common care associated with oncology, orthopedics and ENT care for patients under the age of 18. The company framed the change as a part of its ongoing commitment to eliminate 30% of all pre-care reimbursement approvals by 2027.
READ MORE >

CVS Health to spin off its retail pharmacies into new company after regulatory pressure

The big announcement was made on Wednesday, and many of the details are still being worked out ahead of the planned 2028 split of the company. For now, the plan is for CVS Health to retain its core Caremark and Aetna businesses, with the pharmacy company to take over prescription drug sales and urgent care services.

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cvs-health-healthhub-location-at-cvs-pharmacy-store-image.jpg
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CVS Health to spin off its retail pharmacies into new company after regulatory pressure

Share on Twitter Share on Facebook Share on Linkedin
cvs-health-healthhub-location-at-cvs-pharmacy-store-image.jpg
The big announcement was made on Wednesday, and many of the details are still being worked out ahead of the planned 2028 split of the company. For now, the plan is for CVS Health to retain its core Caremark and Aetna businesses, with the pharmacy company to take over prescription drug sales and urgent care services.
READ MORE >

Featured Articles

FTC warns 25 insurance brokers not to engage in deceptive marketing for ACA plans

The agency did not name the companies or accuse them of wrongdoing. Instead, it told the companies they are ‘on notice’ and reminded them about federal laws, including the limited use of telemarketing.

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smartphone.jpg
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FTC warns 25 insurance brokers not to engage in deceptive marketing for ACA plans

Share on Twitter Share on Facebook Share on Linkedin
smartphone.jpg
The agency did not name the companies or accuse them of wrongdoing. Instead, it told the companies they are ‘on notice’ and reminded them about federal laws, including the limited use of telemarketing.
READ MORE >

$227M Medicare fraud scheme involving Pakistani data firm ends in guilty plea

Syed Murtuza Kablazada, 36, an Indian national and resident of Illinois, could spend 20 years behind bars for submitting false medical claims for COVID-19 tests to the federal healthcare program. Authorities said Medicare paid out $136 million for lab results that were faked.

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Covid Test
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$227M Medicare fraud scheme involving Pakistani data firm ends in guilty plea

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Covid Test
Syed Murtuza Kablazada, 36, an Indian national and resident of Illinois, could spend 20 years behind bars for submitting false medical claims for COVID-19 tests to the federal healthcare program. Authorities said Medicare paid out $136 million for lab results that were faked.
READ MORE >

Healthcare groups ask for delay of new Medicare payment model, citing technical difficulties

In an open letter, the American Hospital Association and American Medical Association, among others, are asking regulators to delay the rollout of the Ambulatory Specialty Model, a value-based reimbursement structure for patients with heart failure and lower back pain.

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back_pain.jpg
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Healthcare groups ask for delay of new Medicare payment model, citing technical difficulties

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back_pain.jpg
In an open letter, the American Hospital Association and American Medical Association, among others, are asking regulators to delay the rollout of the Ambulatory Specialty Model, a value-based reimbursement structure for patients with heart failure and lower back pain.
READ MORE >

In Case You Missed It

Last year’s healthcare data breach at Oracle impacted 20M people: Report

The hack, which was revealed earlier this year in a report from Bleeping Computer, is said to have been limited to a legacy server. Oracle denied its cloud environment had been compromised. 

READ MORE >
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Last year’s healthcare data breach at Oracle impacted 20M people: Report

Share on Twitter Share on Facebook Share on Linkedin
The hack, which was revealed earlier this year in a report from Bleeping Computer, is said to have been limited to a legacy server. Oracle denied its cloud environment had been compromised. 
READ MORE >

FTC sends warning to dozens of hospitals over price transparency failures

The agency is warning hospitals that failing to publicly post the prices they charge for services will not only elicit the ire of HHS.

READ MORE >
FTC Apex Building
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FTC sends warning to dozens of hospitals over price transparency failures

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FTC Apex Building
The agency is warning hospitals that failing to publicly post the prices they charge for services will not only elicit the ire of HHS.
READ MORE >

In Other News

CCTA matches IVUS for PCI guidance: Imaging expert Carlos Collet breaks down the data

In terms of the study's primary endpoint, using CCTA to guide procedures was noninferior to IVUS. CCTA was also linked to certain advantages over IVUS, including improved cath lab efficiency. 

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Carlos Collet, MD, PhD, Director, Cardiovascular Imaging, Physiology, and Translational Therapeutics, Cardiovascular Research Foundation (CRF), explains the P4 trial, which found CCTA-guided PCI is more efficient than IVUS-guided PCI.
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CCTA matches IVUS for PCI guidance: Imaging expert Carlos Collet breaks down the data

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Carlos Collet, MD, PhD, Director, Cardiovascular Imaging, Physiology, and Translational Therapeutics, Cardiovascular Research Foundation (CRF), explains the P4 trial, which found CCTA-guided PCI is more efficient than IVUS-guided PCI.
In terms of the study's primary endpoint, using CCTA to guide procedures was noninferior to IVUS. CCTA was also linked to certain advantages over IVUS, including improved cath lab efficiency. 
READ MORE >

Medicare finalizes plan to slash $9B in imaging spending through site-neutral reforms

First proposed in July, CMS on Jan. 1 will begin reimbursing for certain noncontrast, hospital-based outpatient imaging using the lower physician fee schedule rate. 

READ MORE >
hospital money health system
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Medicare finalizes plan to slash $9B in imaging spending through site-neutral reforms

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hospital money health system
First proposed in July, CMS on Jan. 1 will begin reimbursing for certain noncontrast, hospital-based outpatient imaging using the lower physician fee schedule rate. 
READ MORE >

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