Pharmacy benefit manager Prime Therapeutics is expanding its partnership with Sempre Health, a company that applies discounts at the pharmacy counter for people taking single-source drugs for chronic ...

Physicians get a 2.5% pay increase in the 2026 Medicare Physician Fee Schedule Final Rule released by the Centers for Medicare and Medicaid Services on Friday. The rule also includes provisions for ...

Meeting budgets and deadlines may not reflect the scalability and viability of AI projects, according to HIMSS' Rob Havasy and PMI's Karla Eidem; leaders must align stakeholders, own outcomes and ...

A new report released jointly by AHIP and the Blue Cross Blue Shield Association estimates that up to 39% of out-of-network claims submitted to the federal independent dispute resolution (IDR) process ...

Providers know instantly what’s covered, payers receive more comprehensive claims and patients know their coverage before ...

For those paying the full cost of medications, the new model will reduce the monthly cost for brand-name prescriptions by an ...

Many Medicare Advantage and Medicaid managed care plans have limited networks of behavioral care providers, necessitating ...

New York Governor Kathy Hochul has set aside about $2.6 billion in state investments to strengthen and modernize electronic ...

Beneficiaries struggle to make a decision when faced with so many choices on cost and coverage and often seek assistance from ...

Centene saw a net loss of $6.6 billion in Q3 despite slightly outperforming in the quarter, with the loss linked to a $6.7 ...

Manufacturer EMD Serono is engaged by the Trump administration to bring the price of the medicine down by 84%.