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News You Need to Know Today
CMS takes on ‘ghost networks,’ PBMs with new regulatory framework | FDA braces for AI adoption wave | $6M Medicare fraud plea
Monday, October 19, 2026
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Today's News and Trends

CMS proposes new regulations to eliminate ‘ghost networks’ and improve PBM transparency

Released Friday, the proposed rule is designed to comply with an act of Congress passed in February. Changes include regular audit requirements for Medicare Advantage coverage networks and enhanced reporting for pharmacy benefit managers.

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CMS proposes new regulations to eliminate ‘ghost networks’ and improve PBM transparency

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Released Friday, the proposed rule is designed to comply with an act of Congress passed in February. Changes include regular audit requirements for Medicare Advantage coverage networks and enhanced reporting for pharmacy benefit managers.
READ MORE >

FDA balances faster AI adoption with safety as healthcare technology advances

Insider explains how the FDA is spearheading the Trump administration's push for faster AI adoption in healthcare.

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Aubrey Shick, a digital health policy expert on regulatory and product strategy, and a former Senior Digital Health Advisor at the U.S. Food and Drug Administration (FDA), explains how the Trump administration's push for faster artificial intelligence (AI) adoption in healthcare is being done and challenges for the FDA amid government downsizing.
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FDA balances faster AI adoption with safety as healthcare technology advances

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Aubrey Shick, a digital health policy expert on regulatory and product strategy, and a former Senior Digital Health Advisor at the U.S. Food and Drug Administration (FDA), explains how the Trump administration's push for faster artificial intelligence (AI) adoption in healthcare is being done and challenges for the FDA amid government downsizing.
Insider explains how the FDA is spearheading the Trump administration's push for faster AI adoption in healthcare.
READ MORE >

Straw ‘owner’ of durable medical device company pleads guilty for role in $6M Medicare fraud conspiracy

The scam resulted in Medicare paying out more than $3 million for back and knee braces that doctors never prescribed and patients did not need, the U.S. Department of Justice said.

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doctor looking at CLTI patient's leg
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Straw ‘owner’ of durable medical device company pleads guilty for role in $6M Medicare fraud conspiracy

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doctor looking at CLTI patient's leg
The scam resulted in Medicare paying out more than $3 million for back and knee braces that doctors never prescribed and patients did not need, the U.S. Department of Justice said.
READ MORE >

Featured Articles

Healthcare CEO sentenced to 19 years for role in $1B Medicare fraud scheme

Brett Blackman, 43, of Kansas was convicted by a jury in April of healthcare fraud, stemming from an extensive conspiracy to issue bogus prescriptions for unnecessary medical devices. 

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Medicare fraud
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Healthcare CEO sentenced to 19 years for role in $1B Medicare fraud scheme

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Medicare fraud
Brett Blackman, 43, of Kansas was convicted by a jury in April of healthcare fraud, stemming from an extensive conspiracy to issue bogus prescriptions for unnecessary medical devices. 
READ MORE >

Labcorp to buy medical diagnostics company, proprietary prostate cancer test in $872M deal

Once the deal closes, BioReference and its FDA-approved 4Kscore Test—currently owned by Opko Health—will become part of Labcorp, allowing it to expand its blood testing capabilities.

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scan of prostate
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Labcorp to buy medical diagnostics company, proprietary prostate cancer test in $872M deal

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scan of prostate
Once the deal closes, BioReference and its FDA-approved 4Kscore Test—currently owned by Opko Health—will become part of Labcorp, allowing it to expand its blood testing capabilities.
READ MORE >

HHS eliminates health insurance subsidies for 189K 'duplicate’ enrollees as part of ongoing audit

The Centers for Medicare & Medicaid Services said the cancelled payments are linked to people enrolled twice in the system, as well as those found to be deceased. Determinations are subject to a 30-day appeal of any errors made during the purge. 

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Bobby Kennedy Jr
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HHS eliminates health insurance subsidies for 189K 'duplicate’ enrollees as part of ongoing audit

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Bobby Kennedy Jr
The Centers for Medicare & Medicaid Services said the cancelled payments are linked to people enrolled twice in the system, as well as those found to be deceased. Determinations are subject to a 30-day appeal of any errors made during the purge. 
READ MORE >

In Case You Missed It

State AGs call for federal AI regs without further ado; Big Tech insider suspects cynical motives behind AI doomsday warnings

Some 26 attorneys general have signed onto an initiative urging Congress to federally regulate the AI industry “immediately.” One of the voices countering the call is coming from inside the Big Tech arena. 

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fleeing AI apocalypse
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State AGs call for federal AI regs without further ado; Big Tech insider suspects cynical motives behind AI doomsday warnings

Share on Twitter Share on Facebook Share on Linkedin
fleeing AI apocalypse
Some 26 attorneys general have signed onto an initiative urging Congress to federally regulate the AI industry “immediately.” One of the voices countering the call is coming from inside the Big Tech arena. 
READ MORE >

Lawsuit from Medicaid enrollees, provider advocacy groups challenges ‘Big, Beautiful’ work requirements

Five beneficiaries of the safety-net healthcare program have sued with the support of the National Health Law Program. They are joined by prestigious industry lobbies, including the American Academy of Pediatrics.

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Lawsuit from Medicaid enrollees, provider advocacy groups challenges ‘Big, Beautiful’ work requirements

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Five beneficiaries of the safety-net healthcare program have sued with the support of the National Health Law Program. They are joined by prestigious industry lobbies, including the American Academy of Pediatrics.
READ MORE >

In Other News

Clinicians from all specialties use AI to answer cardiology questions

Overall, more than 950,000 clinicians submitted queries to a popular AI platform from January 2024 to June 2026. Cardiovascular care was a common topic, especially questions about specific treatments and medications. 

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AI healthcare doctor surgery procedure artificial intelligence
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Clinicians from all specialties use AI to answer cardiology questions

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AI healthcare doctor surgery procedure artificial intelligence
Overall, more than 950,000 clinicians submitted queries to a popular AI platform from January 2024 to June 2026. Cardiovascular care was a common topic, especially questions about specific treatments and medications. 
READ MORE >

Acute imaging contrast reactions costing hospitals big bucks

“Our findings help quantify how these adverse events increase estimated direct medical costs and negatively affect radiology workflow," experts write in JACR. 

READ MORE >
Iodine contrast being loaded into a contrast injector in preparation for a cardiac CT scan at Duly Health and Care in Lisle, Illinois. The contrast shortage is causing some healthcare organizations to postpone exams and procedures and ration contrast supplies. Photo by Dave Fornell
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Acute imaging contrast reactions costing hospitals big bucks

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Iodine contrast being loaded into a contrast injector in preparation for a cardiac CT scan at Duly Health and Care in Lisle, Illinois. The contrast shortage is causing some healthcare organizations to postpone exams and procedures and ration contrast supplies. Photo by Dave Fornell
“Our findings help quantify how these adverse events increase estimated direct medical costs and negatively affect radiology workflow," experts write in JACR. 
READ MORE >

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