Epic dismisses claims against SelfRx in medical record misuse lawsuit
Emily Olsen / healthcaredive - The EHR vendor accused SelfRx of retrieving over 100,000 records for financial gain in the high-profile lawsuit. Now, the chronic condition management firm said it doesn’t know who took the records.
AI Summary: A judge has dismissed claims against Epic in litigation alleging misuse of patient records involving pharmacy‑linked defendant SelfRx. The ruling narrows the case and leaves ongoing questions about third‑party access to electronic health records, vendor liability and data governance, underscoring persistent tensions in health IT and patient privacy.
Eli Lilly's ultimatum to hospitals: Send 340B claims data by June 1 or lose discounts
fiercehealthcare - The drugmaker has issued a June 1 ultimatum to an unspecified number of hospitals that have resisted a data submission policy it implemented in February. Furious hospital industry groups are pushing back, calling the decision unlawful and urging the admin…
AI Summary: Eli Lilly has given hospitals an ultimatum: submit 340B claims data within a tight deadline or lose drug discounts. The move pressures health systems to comply quickly, raising questions about administrative burden, data-sharing logistics and potential financial strain for safety-net providers that rely on the program’s savings.
CMS releases Medicaid work requirements guidance for states
Rebecca Pifer Parduhn / healthcaredive - The highly anticipated interim final rule weighs in on key issues for states hustling to operationalize work requirements before the 2027 deadline. But there’s still some gray area — and lots of critics.
AI Summary: The Centers for Medicare & Medicaid Services released a national framework for implementing Medicaid work requirements, giving states guidance on eligibility, reporting and enforcement. The directive outlines guardrails and operational expectations while leaving significant discretion to states, prompting debate over access, administrative burden and potential gaps in coverage during rollout.
Massachusetts sues UnitedHealthcare over alleged $100M in fraudulent Medicaid payments
Elizabeth Casolo / beckershospitalreview - Massachusetts filed a lawsuit against UnitedHealthcare, accusing the insurer of retaining more than $100 million in fraudulent Medicaid payments. The May 29 complaint, filed in a state court, focuses on UnitedHealthcare’s role as a contractor for “Senior …
AI Summary: The Massachusetts attorney general filed a civil suit accusing UnitedHealthcare of submitting improper Medicaid payments, alleging roughly $100 million in fraudulent claims tied to managed‑care contracts. The action seeks recovery and oversight remedies as state regulators press insurers on billing practices, underscoring growing scrutiny of Medicaid managed‑care arrangements.
UnitedHealthcare to nix nearly two thirds of pediatric prior auths
fiercehealthcare - UnitedHealthcare is set to eliminate close to two-thirds of pediatric prior authorization requirements by the end of the year.
AI Summary: UnitedHealthcare announced a major rollback of pediatric prior authorization requirements, eliminating roughly two‑thirds of those rules to reduce administrative burden and speed care for children. The move aims to ease clinician frustration and patient delays, while insurers and providers brace for workflow and cost‑management implications.
Care navigation startup Garner Health banks $100M series E at $2.74B valuation
fiercehealthcare - The startup plans to use the capital to expand its provider quality platform, scale AI-powered product innovation and expand access.
AI Summary: Care navigation platform Garner Health closed a $100 million financing round to scale patient navigation and referrals to high‑performing clinicians, drawing strategic participation including Kaiser. The funding fuels expansion of tech‑enabled matchmaking between patients and clinicians while investors chase better outcomes and lower downstream costs.
Walmart, Teladoc Team Up to Expand Access to Virtual Care
Marissa Plescia / medcitynews - Through a new partnership, Teladoc Health’s virtual services are now available on Walmart’s Better Care Services platform.The post Walmart, Teladoc Team Up to Expand Access to Virtual Care appeared first on MedCity News.
AI Summary: Walmart has integrated Teladoc’s virtual care services into its digital health platform, rolling out expanded telemedicine access through its channels. The partnership merges Teladoc’s clinical offerings with Walmart’s scale to lower barriers to care, steer routine visits online, and extend convenient virtual options to price‑sensitive consumers — because waiting rooms are so last century.
CMS Finalizes Rule to Simplify Payer-Provider Disputes Under No Surprises Act
Katie Adams / medcitynews - CMS finalized a new rule aimed at streamlining the No Surprises Act’s overwhelmed arbitration system. Provider groups largely welcomed the reforms — though some industry leaders said additional changes are still needed to address alleged misuse and improv…
AI Summary: The Centers for Medicare & Medicaid Services finalized a rule to simplify payer‑provider disputes under the No Surprises Act, updating the dispute resolution process and implementing a payer registry and portal changes. The aim is to reduce administrative friction, speed dispute handling, and make billing arbitration less of an endurance sport for providers and insurers.
- Final rule: new portal and payer registry details (3)
- Insurers push back; provider legal fights over payments (3)
- Patient fallout: medical debt and surprise billing stories (3)
Final rule: new portal and payer registry details
Insurers push back; provider legal fights over payments
Patient fallout: medical debt and surprise billing stories
Smart ring maker Oura files confidentially for IPO as consumer demand propels revenue growth
fiercehealthcare - Oura, the smart ring maker, filed confidentially for an initial public offering after it reached an $11 billion valuation last year.
AI Summary: Ōura has quietly filed confidential paperwork to go public, leveraging surging consumer demand for its smart rings and an aggressive pivot into healthcare data and services. The company is pitching its wearable as a clinical-grade monitoring platform to insurers and providers, aiming to monetize sleep, activity and biometrics while navigating privacy and regulatory scrutiny.
How state laws can stymie research into your ancestors' psychiatric records
abcnews - Frustrated family members and others have been pushing for law changes in New York and other states that would allow the release of mental health records of long-dead ancestors
AI Summary: Legal researchers warn that a patchwork of state statutes and privacy rules is blocking access to historical psychiatric records needed for family‑history and population‑level studies. The restrictions complicate efforts to understand intergenerational mental‑health patterns and hamper reproducible research, leaving scientists to navigate inconsistent consent, archival access, and litigation risks.
Abridge names chief technology officer
Giles Bruce / beckershospitalreview - San Oo has been named chief technology officer of healthcare AI startup Abridge. Mr. Oo was most recently senior vice president of engineering at AI workspace developer Notion. He previously cofounded two tech companies that were acquired by LinkedIn and …
AI Summary: Abridge has appointed a new chief technology officer to lead its product and engineering strategy, signaling a push to scale its clinical AI tools and platform capabilities. The hire aims to strengthen technical leadership, accelerate development timelines, and reassure customers that the company intends to keep up with the fast-paced demands of healthcare AI — which, ironically, keeps hiring to stop churn.
- AI startups scale via health system partnerships (4)
- Practical challenges: accessibility, training, oversight of clinical AI (6)
- All Other Stories
AI startups scale via health system partnerships
Practical challenges: accessibility, training, oversight of clinical AI
All Other Stories
CommonSpirit $3.4B in the red amid billing contract exit, operational woes
Rebecca Pifer Parduhn / healthcaredive - The Catholic nonprofit giant’s expenses well outstripped revenue in the most recent financial quarter. Though the outcome was mostly due to one-time items, CommonSpirit also continues to struggle with boosting core operations.
AI Summary: CommonSpirit reported a multi‑billion‑dollar shortfall tied to operational challenges and the exit from a major billing contract, recording a substantial loss and a weakened operating margin in the quarter. The results have spurred leadership to reassess financial strategy and cost controls as the system navigates recovery and operational stabilization.
Nourish Secures $100M for Metabolic Health Clinic
Marissa Plescia / medcitynews - Nourish’s Series C round was led by Menlo Ventures, with participation from Thrive Capital, Index Ventures, J.P. Morgan Growth Equity Partners, Maverick Ventures, Y Combinator, BoxGroup, Atomico, Daybreak and Operator Partners.The post Nourish Secures $10…
AI Summary: Nourish secured a $100 million funding round to expand its virtual metabolic-health and nutrition care model, doubling down on physician integration and broader clinical rollout. The company plans to scale tele-nutrition services and deepen provider partnerships to treat metabolic disease at home, aiming to convert weight and metabolic management into reimbursable medical care.
Prosecutors seek NYU hospital information on gender-affirming care for children
abcnews - A New York health care system has received a federal grand jury subpoena issued in Texas seeking information about children who received gender-affirming care and the medical providers who administered it
AI Summary: Federal prosecutors have issued a subpoena seeking NYU Langone medical records related to gender-affirming care for minors, escalating legal scrutiny of hospital practices. Authorities are pursuing documentation and communications as part of an inquiry into pediatric services; the move could prompt broader institutional reviews and legal battles over patient privacy and standards of care.
FDA clears 1st AI sepsis monitoring tool
Giles Bruce / beckershospitalreview - A tool from tech company Bayesian Health has become the first continuous AI sepsis monitor to gain FDA approval. The solution monitors hospital patients to detect deterioration and flag sepsis early on. The application was developed at Baltimore-based Joh…
AI Summary: Regulators have cleared the first AI‑driven sepsis early‑warning system for clinical deployment, enabling hospitals to use algorithmic alerts to identify patients at risk of deterioration earlier. The clearance opens the door for broader adoption of AI in acute care while renewing debates about clinical oversight, false alarms and integration into existing workflows.
CMS launches initiative to speed electronic prior authorization adoption
Emily Olsen / healthcaredive - The effort, part of the agency’s ambitious Health Tech Ecosystem, aims to accelerate the industry’s progress before requirements on electronic prior authorization go into effect next year.
AI Summary: CMS launched a national initiative to accelerate adoption of electronic prior authorization, recruiting major health‑IT vendors and health systems to pilot interoperable digital workflows. The program aims to cut paperwork and speed care decisions by automating approvals, though providers warn integration challenges and real‑world impact will take time to materialize.
- AI and automation firms reshaping prior authorization workflows (4)
- CMS' national push to accelerate electronic prior authorization (3)
- Policy fights, insurer delays and patient impact of prior auth (4)
- All Other Stories
AI and automation firms reshaping prior authorization workflows
CMS' national push to accelerate electronic prior authorization
Policy fights, insurer delays and patient impact of prior auth
All Other Stories
CMS pauses hospice, home health Medicare enrollments in fraud crackdown
fiercehealthcare - The Trump administration has issued a six-month moratorium on hospice and home health agencies enrolling in Medicare as part of its efforts to combat fraud.
AI Summary: CMS has suspended new Medicare enrollments for hospice and home health providers nationwide amid a fraud crackdown, pausing approvals while investigators audit suspicious applications and billing patterns. The freeze seeks to protect patients and taxpayer dollars, though it may delay access where new providers were expected to step in — because apparently some providers preferred creative billing over care.
- Nationwide moratorium on hospice and home health enrollments (4)
- Policy and patient access fallout from the freeze (3)
- White House fraud crackdown and enforcement sweep (4)
- All Other Stories
Nationwide moratorium on hospice and home health enrollments
Policy and patient access fallout from the freeze
White House fraud crackdown and enforcement sweep
All Other Stories
1K steps daily after surgery can cut readmissions by 16%: 3 study notes
Mariah Taylor / beckershospitalreview - Each additional 1,000 steps per day a patient walks after surgery is linked to 18% lower odds of complications, 16% lower readmission rates and 6% shorter hospital stays, researchers found. The study, conducted by researchers at Columbus-based Ohio State …
AI Summary: A simple prescription — roughly 1,000 steps per day after surgery — was linked to a 16% reduction in readmissions in recent studies. Researchers suggest wearable step tracking as an inexpensive, scalable recovery aid that encourages mobility, reduces complications, and nudges postoperative care toward behaviourally realistic, low‑tech interventions that actually work.
Health advice is all over social media. Here's how to vet claims
medicalxpress - Health and wellness advice is available in abundance on social media—from trendy to informative to straight-up disinformation—and you're far from alone in seeing it.
AI Summary: Social media is awash with health advice, much of it anecdote masquerading as evidence. Report outlines practical steps to separate useful guidance from nonsense: check original sources, prefer peer‑reviewed studies and guidelines, question sensational claims, and consult clinicians before acting. Because no, a viral post is not a clinical trial.
Amwell expects smaller losses in 2026 after Q1 performance
Emily Olsen / healthcaredive - The health technology firm’s results give Amwell “increased confidence” it will meet a long-term goal of achieving positive cash flow from operations in the fourth quarter, CFO Mark Hirschhorn said.
AI Summary: Telehealth provider Amwell posted Q1 results showing better-than-expected customer renewals and retention, helping the company forecast smaller losses despite soft revenue. The results suggest operational improvements are stabilizing the business and give investors a slightly less gloomy view of the telehealth market's near-term prospects.