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News You Need to Know Today
AI prior authorizations continue | UHC’s lawsuit against Guardian dismissed | ER nurse distress | Kalshi | OpenAI update
Sunday, July 26, 2026
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This Week’s News

Push to block ‘WISeR’ Medicare prior authorizations dies in the Senate

Democrats in the U.S. Senate attempted to use the Congressional Review Act to force the Centers for Medicare & Medicaid Services to halt a program that uses artificial intelligence to approve or deny claims for medical care submitted to traditional Medicare. The measure failed in a 46-50 vote.

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Push to block ‘WISeR’ Medicare prior authorizations dies in the Senate

Share on Twitter Share on Facebook Share on Linkedin
EFF-WISeR-FOIA-Lawsuit-Image
Democrats in the U.S. Senate attempted to use the Congressional Review Act to force the Centers for Medicare & Medicaid Services to halt a program that uses artificial intelligence to approve or deny claims for medical care submitted to traditional Medicare. The measure failed in a 46-50 vote.
READ MORE >

Judge tosses UnitedHealth’s defamation lawsuit against the Guardian

All six counts of the company’s complaint were dismissed. The lawsuit stems from a May 2025 report from the outlet, where it was alleged the insurer paid incentive payments to nursing homes to reduce hospital transfers.

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Judge tosses UnitedHealth’s defamation lawsuit against the Guardian

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court judge ruling case lawsuit dismissal gavel
All six counts of the company’s complaint were dismissed. The lawsuit stems from a May 2025 report from the outlet, where it was alleged the insurer paid incentive payments to nursing homes to reduce hospital transfers.
READ MORE >

Women ER doctors less reluctant to err on the side of defensive medicine or proactive care—or maybe both

In emergency settings, female physicians order more tests and admit more patients than their male peers. The difference is not pronounced, but its presence suggests women physicians may have a greater tendency to consider peripheral assessment factors. 

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woman doctor physician nurse
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Women ER doctors less reluctant to err on the side of defensive medicine or proactive care—or maybe both

Share on Twitter Share on Facebook Share on Linkedin
woman doctor physician nurse
In emergency settings, female physicians order more tests and admit more patients than their male peers. The difference is not pronounced, but its presence suggests women physicians may have a greater tendency to consider peripheral assessment factors. 
READ MORE >

CMS appeals court ruling on Medicare Advantage star rating methodology as insurers file lawsuits

The agency announced its appeal of a court ruling it lost to Clover Health, which resulted in the agency recalculating the grades it gave to the payer’s Medicare Part C plans. Other insurers are now asking for the same redo, spurring CMS to appeal the initial ruling.

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CMS appeals court ruling on Medicare Advantage star rating methodology as insurers file lawsuits

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Medicare Advantage Part C clipboard payment
The agency announced its appeal of a court ruling it lost to Clover Health, which resulted in the agency recalculating the grades it gave to the payer’s Medicare Part C plans. Other insurers are now asking for the same redo, spurring CMS to appeal the initial ruling.
READ MORE >

Kalshi opens prediction markets to FDA drug development decisions, clinical trial outcomes

Users of the popular online betting marketplace can now wager on specific FDA regulatory scenarios, including when Eli Lilly’s new weight loss drug will be approved, or when camizestrant will be given the greenlight to treat breast cancer.

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betting big on AI artificial intelligence in healthcare
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Kalshi opens prediction markets to FDA drug development decisions, clinical trial outcomes

Share on Twitter Share on Facebook Share on Linkedin
betting big on AI artificial intelligence in healthcare
Users of the popular online betting marketplace can now wager on specific FDA regulatory scenarios, including when Eli Lilly’s new weight loss drug will be approved, or when camizestrant will be given the greenlight to treat breast cancer.
READ MORE >

Emergency nurses know what it’s like to suffer pangs of moral distress

Like the emergency physicians they work alongside, ER nurses experience moral distress in substantial numbers and multifaceted ways, according to a new study published in the Journal of Clinical Nursing.

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Emergency nurses know what it’s like to suffer pangs of moral distress

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nurse in moral distress
Like the emergency physicians they work alongside, ER nurses experience moral distress in substantial numbers and multifaceted ways, according to a new study published in the Journal of Clinical Nursing.
READ MORE >

Netflix actress, model plead guilty to $3.4M Medicaid fraud scheme

The unusual defendants were swept up as part of a larger investigation into healthcare fraud in the Minnesota housing services program. An alleged third co-conspirator has pleaded not guilty and will take her chances at a jury trial.

READ MORE >
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Netflix actress, model plead guilty to $3.4M Medicaid fraud scheme

Share on Twitter Share on Facebook Share on Linkedin
take care of maya netflix johns hopkins lawsuit
The unusual defendants were swept up as part of a larger investigation into healthcare fraud in the Minnesota housing services program. An alleged third co-conspirator has pleaded not guilty and will take her chances at a jury trial.
READ MORE >

Psychiatrists, psychologists spending more than other healthcare providers to lobby policymakers

Payments to lobbyists from healthcare providers fell 13% over a 10-year period ending in 2024. Yet lobbyist spending by one specialty—mental healthcare—rose by nearly 30%. What explains the against-the-current cash flow? 

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psychiatrist mental health
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Psychiatrists, psychologists spending more than other healthcare providers to lobby policymakers

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psychiatrist mental health
Payments to lobbyists from healthcare providers fell 13% over a 10-year period ending in 2024. Yet lobbyist spending by one specialty—mental healthcare—rose by nearly 30%. What explains the against-the-current cash flow? 
READ MORE >

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