340B drug discounts are drifting from patients to profit, and reform is now on the table

medicalxpress - The 340B Drug Pricing Program must be reformed to better patient health and disincentivize institutional profit-seeking behaviors, says the American College of Physicians (ACP). In a new policy, "Reforming 340B to Promote Program Integrity and Better Serv…

AI Summary: The 340B drug-discount program is under renewed scrutiny after analyses and advocacy groups argue discounts intended to help patients are instead boosting institutional margins. Hospitals, provider groups and the AHA are contesting HRSA proposals and court rulings, sparking policy debates and potential regulatory fixes to curb markups and steer savings back to vulnerable patients.

CMS to require states to audit Medicaid providers

Kristin Kuchno / beckershospitalreview - CMS Administrator Mehmet Oz, MD, said his administration will require all states to audit healthcare providers to address alleged Medicaid fraud, Politico reported April 21. Dr. Oz unveiled the plan at Politico’s Health Care Summit. Beginning this week, C…

AI Summary: CMS is requiring states to audit Medicaid providers as part of a new oversight initiative aimed at tightening program integrity and provider revalidation. The policy has sparked high‑level calls for nationwide reviews and a proposed 50‑state audit effort, signaling heightened federal scrutiny and potential changes to enrollment, billing and provider eligibility processes.

Eli Lilly Buys Startup CrossBridge Bio to Bring a More Powerful Strike to Tumors

Frank Vinluan / medcitynews - Eli Lilly is paying up to $300 million for CrossBridge Bio, a startup developing antibody drug conjugates that deliver two drug payloads to cancers. Beyond potentially better efficacy, CrossBio’s dual approach could also fight drug resistance. The post El…

AI Summary: Eli Lilly agreed to acquire CrossBridge Bio for up to $300 million, adding small‑molecule oncology assets to its pipeline. The deal accelerates Lilly’s tumor‑targeting strategy, reflects Big Pharma’s preference for buying nimble biotech innovation, and highlights ongoing consolidation trends that determine where promising oncology programs ultimately end up.

FDA approves Travere's Filspari as first drug for the kidney disease called FSGS

Nicole DeFeudis / endpoints - The FDA expanded the label for Filspari on Monday to add another kidney condition. The drug is now the first therapy approved in the US for focal segmental glomerulosclerosis (FSGS). The pill may be taken ...

AI Summary: The FDA approved Filspari for focal segmental glomerulosclerosis (FSGS), delivering the first specifically authorized treatment for this rare kidney disease. The approval provides a targeted therapeutic option for patients and marks a commercial milestone for Travere, raising hopes for better outcomes while spotlighting questions about access, pricing, and long‑term real‑world effectiveness.

Mount Sinai, Anthem reach 3-year agreement

Elizabeth Casolo / beckershospitalreview - Anthem Blue Cross Blue Shield in New York and New York City-based Mount Sinai Health System have established a three-year agreement, both organizations confirmed to Becker’s. The agreement includes hospitals, physicians and other providers. Mount Sinai sa…

AI Summary: Mount Sinai and Anthem reached a three‑year contract restoring in‑network coverage after negotiations, ending a period of uncertainty for patients and clinicians. The deal averts immediate network disruption and signals both sides' willingness to settle—proof that combat can end in compromise when hospitals and insurers remember patients actually use the services.

Baylor Scott & White Health Plan to exit Medicaid, individual markets; cut 321 jobs

Jakob Emerson / beckershospitalreview - Baylor Scott & White Health Plan said April 14 it will exit the Texas Medicaid managed care market and discontinue its individual marketplace plans, affecting roughly 225,000 members and eliminating 321 jobs statewide, according to the Dallas Morning News…

AI Summary: Baylor Scott & White announced it will leave Medicaid individual markets, a move that will shed hundreds of jobs and reshape coverage options for affected enrollees. The decision highlights ongoing financial pressures in public‑program participation and raises practical concerns about access continuity for people reliant on those plans.

New Bill Seeks to Lower Out-of-Pocket Drug Costs

Marissa Plescia / medcitynews - Rep. Greg Murphy introduced a bill that would require out-of-pocket prescription drug spending to count toward patients’ deductibles and out-of-pocket maximums regardless of where the drugs are purchased.The post New Bill Seeks to Lower Out-of-Pocket Drug…

AI Summary: Lawmakers introduced legislation to reduce out‑of‑pocket drug costs by allowing patients' direct drug purchases to count toward their insurance deductibles. The proposal aims to ease financial strain for people buying costly medications out‑of‑pocket, but would require insurers and pharmacy systems to change longstanding accounting and benefits practices.

Insmed shelves Brinsupri in skin disease after mid-stage flop

Elizabeth Cairns / endpoints - Insmed has given up on Brinsupri in the painful skin disorder hidradenitis suppurativa (HS) after a mid-stage trial failure. The company had ditched the pill in sinus inflammation at the end of last year. The ...

AI Summary: Insmed announced it will halt development of Brinsupri for a dermatologic indication following disappointing mid‑stage trial results. Company commentary stressed the skin setback does not negate Brinsupri’s potential in pulmonary indications, but investors and clinicians will understandably ask for clearer signs of life before buying the comeback story.

Oricell Lands $110M to Take Cell Therapy to New Territory in Cancer

Frank Vinluan / medcitynews - There are no FDA-approved therapies for GPC3, a protein highly expressed by liver cancers. Oricell Therapeutics claims its cell therapy could be best in this class, but it faces competition from companies such as AstraZeneca and Eureka Therapeutics. The p…

AI Summary: Oricell, a China‑based CAR‑T developer, secured fresh financing to accelerate its cell‑therapy programs and support plans to go public. The fundraising will bankroll clinical expansion, manufacturing scale‑up, and regulatory preparations as the company pushes toward broader development and an IPO ambition, positioning it to compete in the crowded CAR‑T market.

Orlando Health fleshes out Alabama footprint with another acquisition

fiercehealthcare - The $10 billion nonprofit plans to acquire RMC Health System from the City of Anniston, building on 2024's big-ticket purchase of five Alabama hospitals from Tenet Healthcare.

AI Summary: Orlando Health continued its regional growth by acquiring an Alabama health system, extending its clinical and operational footprint into the state. The move aims to integrate services, expand care access and consolidate regional networks as health systems seek scale to manage costs and enhance specialty offerings.

Patients Are Using Chatbots to Fight Medical Bills, With Mixed Results

Sarah Kwon / nytimes - While chatbots like Claude and ChatGPT can help narrow the information divide between patients and providers, they can also dispense flawed advice.

AI Summary: Patients increasingly use AI chatbots to challenge medical bills, leveraging automated appeals and negotiation scripts. While chatbots can speed administrative tasks and sometimes reduce balances, outcomes vary and users face inconsistent accuracy and limits in handling complex payer disputes—so yes, convenience at the price of occasional frustration.

CMS proposes mandatory hospital-bundled model for joint replacements

Ella Jeffries / beckershospitalreview - CMS is proposing a mandatory, nationwide episode-based payment model for joint replacements that would hold most hospitals responsible for Medicare spending tied to a patient’s surgery and recovery. Beginning Oct. 1, 2027, the model — referred to as CJR-X…

AI Summary: CMS unveiled a plan to make hospitals participate in a mandatory bundled-payment model for joint replacement surgeries, offering a 2.4% payment increase tied to the new program. The proposal would standardize payment and care pathways nationwide, shifting financial and operational risk onto hospitals while aiming to curb costs and improve outcomes.

Gilead continues dealmaking streak with $3.15B Tubulis buy for ADCs

Kyle LaHucik / endpoints - In its third acquisition of 2026, Gilead is spending $3.15 billion upfront to snag a next-generation antibody-drug conjugate platform from German startup Tubulis. The California biopharma could pay out another $1.85 billion down the road ...

AI Summary: Gilead Sciences struck a multibillion-dollar acquisition to add Tubulis and bolster its oncology pipeline, buying into antibody-drug conjugate technology. The deal signals Gilead’s strategic pivot to expand beyond infectious disease into cancer therapeutics, accelerating access to novel modalities and reshaping competitive dynamics in biopharma.

AbbVie sues HHS over 340B patient definition

Ella Jeffries / beckershospitalreview - AbbVie has filed a lawsuit challenging federal guidance on how “patient” is defined under the 340B program, according to an April 8 press release. The company said the current definition, based on guidance issued in 1996, allows covered entities to claim …

AI Summary: AbbVie has filed suit challenging HHS’s interpretation of the 340B program, arguing the agency’s “patient” definition and related guidance are outdated and legally flawed. The company seeks judicial clarity that could reshape who qualifies for discounted drugs and how hospitals and manufacturers navigate the program — yes, the pricing drama continues.

RFK Jr. launching health podcast to expose ‘hypocrisy’ and ‘corruption’

fiercehealthcare - Robert F. Kennedy Jr. is starting a podcast. Unveiling the show on social media, the Department of Health and Human Services (HHS) secretary framed the podcast as a response to public health problems that he said have made “many of us ... come to the conc…

AI Summary: Robert F. Kennedy Jr. is debuting a health-focused podcast promising to call out what he characterizes as hypocrisy and corruption in medicine and public health. The show aims to amplify skeptical takes on mainstream health institutions and policies, positioning itself as a combative platform for contrarian voices and investigations.

Digital health startups raked in $4B during Q1 with 12 megadeals driving investment: Rock Health

fiercehealthcare - Digital health startups pocketed $4 billion in venture capital funding in the first quarter of 2026, marking the strongest first quarter since the pandemic peak.

AI Summary: Venture investment in digital health is narrowing: a small number of startups captured a large share of Q1 funding, driven by a handful of megadeals. The trend signals investor preference for later‑stage companies and scale plays, squeezing early innovators who must now demonstrate clearer paths to durable revenue and clinical impact.

Neurocrine Biosciences Acquires Soleno Therapeutics for $2.9B to Expand Rare Disease Portfolio

oncodaily - Neurocrine Biosciences has entered into a definitive agreement to acquire Soleno Therapeutics, marking a strategic expansion into rare disease treatments and strengthening its late-stage pipeline. The deal signals continued consolidation […]

AI Summary: Neurocrine Biosciences agreed to acquire Soleno Therapeutics for $2.9 billion, picking up Soleno’s Prader‑Willi treatment candidate and bolstering its rare‑disease portfolio. The purchase folds Soleno’s clinical assets and research teams into Neurocrine, positioning the buyer to commercialize a potential high‑value therapy while shoring up long‑term pipeline growth.