An OIG report found that the three largest Medicare Advantage insurers denied prior authorization requests for long-term acute care and inpatient rehabilitation at higher rates than other MA plans in 2024. The post OIG: 3 Largest MA Insurers Deny Prior Auth Requests at High Rates for Long-Term Acute Care, Inpatient Rehab appeared first on MedCity News.

FDA concerns about Amgen’s Tavneos were sparked by securities fraud litigation against ChemoCentryx, the company that originally developed the rare disease drug. The FDA wants to withdraw Tavneos’s approval, citing safety risks and alleged manipulation of the drug’s clinical trial data. The post Amgen Turns to an Independent Review to Defend Rare Disease Drug in FDA Crosshairs appeared first on MedCity News.

The healthcare industry is spending more than ever on AI — but according to executives from Oracle Health, HCA Healthcare and BJC Health, much of that investment could be wasted. During a panel this week at HFMA’s annual conference, they argued that no amount of sophisticated tech can overcome a broken, antiquated data foundation. The post Bot vs. Bot: Why Healthcare AI Progress Might Be Stuck appeared first on MedCity News.

Winning in health-tech is about giving buyers enough operational clarity, early enough, that they can say yes with confidence rather than saying yes because the alternative is another six months of the same evaluation cycle. The post Stop Presenting at Health-Tech Buyers — Let Them Drive appeared first on MedCity News.

Insecurity about transportation can lead to missed appointments and delayed care, and obstacles are more common for cancer patients than for the general population. The post Reliable Transportation Isn’t a Luxury — It’s an Important Part of Cancer Care appeared first on MedCity News.

Bright overhead lighting, constant alarms, hard surfaces, and abrupt transitions between spaces can trigger agitation, confusion, and sensory overload. These reactions are not incidental; they directly affect recovery, staff workload, and cost. The post Designing Care Environments for Sensory Regulation, Not Just Clinical Efficiency appeared first on MedCity News.

Clinical AI startup Abridge held a New York City event to signal it’s done being thought of as just an AI scribe. The company announced a Nvidia foundation model partnership, an Eli Lilly investment, new capabilities for its platform, and the intent to help mediate the relationship between payers and providers. The post Abridge Goes Beyond Documentation: 4 Updates appeared first on MedCity News.

At AHIP 2026, healthcare leaders raised concerns about CMS’ new Medicaid eligibility requirements, with one urging the agency to give states more time to implement them. The post Healthcare Leader to CMS on New Medicaid Eligibility Requirements: Give States an Extension appeared first on MedCity News.

Novartis said its RNA therapy del-brax met goals of a Phase 1/2 study in facioscapulohumeral muscular dystrophy (FSHD), an inherited muscle disorder that currently has no FDA-approved medicines. Del-brax is one of three RNA therapies from Novartis’s $12 billion acquisition of Avidity Biosciences. The post Novartis RNA Med From $12B Deal Keeps Building Case to Become First Therapy for Rare Muscle Disease appeared first on MedCity News.

The next phase of AI in healthcare is about building systems where human clinicians, supervisors, and AI can all contribute, challenge each other, and improve how decisions are made. The post From Copilots to Clinical Judgment: The Next Phase of AI in Digital Behavioral Health appeared first on MedCity News.

AI is not driving healthcare cost inflation. It is exposing a system that has always been designed to reward it, and making that system more efficient. As long as reimbursement is tied to intensity, every technological advancement will move in the same direction: toward maximizing it. The post AI Is Scaling Healthcare Costs Because the System Was Built That Way appeared first on MedCity News.

EHR switching involves risk. But taking a life cycle view, considering data migration, workflow configuration, training, downtime, ongoing fees and eventual exit terms, can put an end to your EHR pain. The post What Healthcare Leaders Get Wrong About EHR Switching appeared first on MedCity News.

The Digital Medicine Society launched an initiative to help payers and virtual care providers avoid common contract implementation challenges. The post DiMe Launches New Initiative for Virtual-First Care appeared first on MedCity News.

During a panel at HFMA’s annual conference, two healthcare credit analysts said the industry is already fracturing into winners and losers. And with 2030 bringing a perfect storm of demographic pressure, reimbursement cuts and AI disruption, they think window for bold action is closing fast. The post ‘2030 Scares Me to Death’: Credit Analysts’ Urgent Warning for Healthcare CFOs appeared first on MedCity News.