April 23, 2025
| This week’s payer news for healthcare leaders
A new regulation pending in front of the Office of Management and Budget suggests the Trump administration may be moving to overhaul the controversial financing mechanism.
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The law in particular will affect CVS and UnitedHealth, both of which operate physical pharmacies in the state along with specialty and mail-order pharmacy businesses.
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During a ceremony at the Oval Office, Mehmet Oz said he would focus on reducing chronic disease, “modernizing” Medicare and Medicaid, and targeting fraud, waste and abuse in government insurance offerings.
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Investors balked last week after UnitedHealth reported first-quarter MA utilization grew at twice its expected rate. Yet Elevance said spending was in line with expectations, a development one analyst called surprising.
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An OMB document proposes to cut the HHS budget by roughly one-third as well as eliminate several divisions and programs.
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The healthcare juggernaut’s results came in unusually below Wall Street’s expectations and caused its stock to plummet Thursday. The development bodes ill for the rest of the managed care sector, analysts said.
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The decision, which Humana disclosed in a Tuesday filing with the court overseeing its lawsuit against the HHS, will be reviewed by Dr. Mehmet Oz, the new CMS administrator.
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