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News You Need to Know Today
November Highlights: Deadly errors | 'Doctor' defined? | 2026 physician fee schedule | UnitedHealth ends RPM reimbursement
Wednesday, December 3, 2025
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The Month in Review

Teen girl dies after hospital misdiagnoses her with hormonal condition that affects men

According to a lawsuit, Jasmine Vincent, 15, was diagnosed by providers at MainHealth’s Mid Coast Medical Group with gynecomastia—a condition that typically affects males. She later died of leukemia-related cardiac arrest. Her mother was awarded $25 million in damages.

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Teen girl dies after hospital misdiagnoses her with hormonal condition that affects men

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Medical malpractice gavel diagnostic error mistake stethoscope
According to a lawsuit, Jasmine Vincent, 15, was diagnosed by providers at MainHealth’s Mid Coast Medical Group with gynecomastia—a condition that typically affects males. She later died of leukemia-related cardiac arrest. Her mother was awarded $25 million in damages.
READ MORE >

Patient dies when surgical 'blade' is left inside him, spurring $1M malpractice lawsuit

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. 

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Patient dies when surgical 'blade' is left inside him, spurring $1M malpractice lawsuit

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surgery
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. 
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Court dismisses nurse practitioners’ lawsuit challenging definition of ‘doctor’

The court's ruling is backed by the American Medical Association, which submitted an amicus brief arguing that "scope creep" threatens patient safety. 

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American Medical Association AMA
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Court dismisses nurse practitioners’ lawsuit challenging definition of ‘doctor’

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American Medical Association AMA
The court's ruling is backed by the American Medical Association, which submitted an amicus brief arguing that "scope creep" threatens patient safety. 
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CMS 2026 physician fee schedule emphasizes chronic disease management, includes pay raise

The Centers for Medicare & Medicaid Services announced a 3.26% reimbursement increase for all providers, with those enrolled in alternative payment models seeing a higher rise.

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The Medicare Physician Fee Schedule again has reductions for payments physicians receive. Medicare Money
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CMS 2026 physician fee schedule emphasizes chronic disease management, includes pay raise

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The Medicare Physician Fee Schedule again has reductions for payments physicians receive. Medicare Money
The Centers for Medicare & Medicaid Services announced a 3.26% reimbursement increase for all providers, with those enrolled in alternative payment models seeing a higher rise.
READ MORE >

Telehealth ketamine service sued after patient dies of overdose

Mindbloom, a telemedicine company that provides ketamine for depression and anxiety as part of a treatment program, is accused of negligence in the death of Philip Ward. But the facts leading up to his overdose are in dispute. 

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Telehealth ketamine service sued after patient dies of overdose

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candles funeral dead respect
Mindbloom, a telemedicine company that provides ketamine for depression and anxiety as part of a treatment program, is accused of negligence in the death of Philip Ward. But the facts leading up to his overdose are in dispute. 
READ MORE >

UnitedHealthcare bucks Medicare, ends reimbursement for most RPM services

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.

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UnitedHealthcare bucks Medicare, ends reimbursement for most RPM services

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UnitedHealthcare UHC UnitedHealth
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.
READ MORE >

GLP-1 weight loss drugs will now be covered by Medicare and Medicaid—and available at a discount through TrumpRx

Novo Nordisk and Eli Lilly have agreed to sell their popular Wegovy and Zepbound injectables through TrumpRx.gov for a discounted rate, as the White House promises that Medicaid and Medicare plans will begin covering the costs. 

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TrumpRx.gov Screenshot
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GLP-1 weight loss drugs will now be covered by Medicare and Medicaid—and available at a discount through TrumpRx

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TrumpRx.gov Screenshot
Novo Nordisk and Eli Lilly have agreed to sell their popular Wegovy and Zepbound injectables through TrumpRx.gov for a discounted rate, as the White House promises that Medicaid and Medicare plans will begin covering the costs. 
READ MORE >

Cigna announces new copay-centric insurance model, backed by AI care coordination

Dubbed “Clearity,” the new health plans will have four tiers to choose from, allowing patients to select the provider and services that are right for them. The insurance is similar to a concierge care model, but backed by a potentially larger network.

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Cigna, one of the nation’s largest health insurance providers, announced new priorities for its capital deployment, including steering an additional $450 million into Cigna Ventures.
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Cigna announces new copay-centric insurance model, backed by AI care coordination

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Cigna, one of the nation’s largest health insurance providers, announced new priorities for its capital deployment, including steering an additional $450 million into Cigna Ventures.
Dubbed “Clearity,” the new health plans will have four tiers to choose from, allowing patients to select the provider and services that are right for them. The insurance is similar to a concierge care model, but backed by a potentially larger network.
READ MORE >

Cybersecurity researcher provides more details on $200K ransom pinned on Doctor Alliance

The outlet DataBreaches.net was able to gather more details on the alleged hack of the healthcare billing automation platform, said to be perpetrated by a notorious cybercriminal.

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Cybersecurity researcher provides more details on $200K ransom pinned on Doctor Alliance

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cybersecurity hacker ransomware cyber data breach
The outlet DataBreaches.net was able to gather more details on the alleged hack of the healthcare billing automation platform, said to be perpetrated by a notorious cybercriminal.
READ MORE >

Doctor sues Waymo after AI flags him as a terrorist

Nasser Mohamed, MD, a neurologist who operates a clinical practice in San Francisco, said an artificial intelligence system used by the autonomous taxi company led to him being denied multiple rides. He is seeking injunctive relief.

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Waymo Creative Commons Image
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Doctor sues Waymo after AI flags him as a terrorist

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Waymo Creative Commons Image
Nasser Mohamed, MD, a neurologist who operates a clinical practice in San Francisco, said an artificial intelligence system used by the autonomous taxi company led to him being denied multiple rides. He is seeking injunctive relief.
READ MORE >

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