NEWS

Is the government accidentally helping criminals? The country's biggest Medicaid carrier thinks so, and they’ve just issued a high-stakes demand for a regulatory overhaul. Key Takeaways Centene's seven-point reform push —The Medicaid market leader sent the U.S. Centers for Medicare and Medicaid Services (CMS) a formal letter urging the agency to overhaul what it calls a "complex web of regulations" that slow fraud investigations. Payment suspension delays are a core complaint

What if the biggest breakthrough in prior authorization isn't a single piece of technology, but the collaboration behind it? Key Takeaways Ambient AI is evolving —The same technology that transformed clinical documentation is now being deployed to tackle the notoriously slow and burdensome prior authorization process. Partnerships are essential —Leading AI companies aren't going it alone; they're forming strategic alliances with payers, providers, and health information netwo

While the broader Medicare Advantage market stumbles, a quieter revolution is reshaping how America's most vulnerable seniors get their coverage. Smart insurers are racing to get ahead of it.