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175 issues since July 6, 2026. Rules, money, and medicine, decoded daily.
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The Service Line · Oct 9 The Service Line issue for October 9, 2026. The Ledger · Oct 9 Humana's stock jumped almost 13 percent after the closing bell Thursday and Alignment Healthcare's fell more than 20 percent, both because of one federal data release: the Centers for Medicare and Medicaid Services (CMS) 2027 Medicare Advantage Star Ratings, which decide how much quality bonus money each insurer collects in 2028. The Ledger · Oct 10 Viatris, the generic and branded drugmaker, agreed October 8 to buy Pacira BioSciences, maker of the non-opioid pain drugs Exparel and Zilretta, for $36.50 a share in cash, an equity value of about $1.65 billion.
Follow a story timelines built from our own coverage
Story · 6 updates
Drugmakers face Thursday deadline to opt into 340B rebate model
- + 1 earlier update
- Aug 1, 2026 HRSA expands 340B rebate pilot to 25 drugs as court curbs drugmaker rebate models
- Aug 6, 2026 HRSA revives 340B rebate pilot with August 24 opt-in deadline for drugmakers
- Aug 9, 2026 Bipartisan Senate bill would terminate HRSA's 340B rebate pilot within a year
- Aug 20, 2026 HRSA revives 340B rebate pilot, sets manufacturer deadline
- Aug 23, 2026 Drugmakers face Thursday deadline to opt into 340B rebate model
Story · 4 updates
CMS locks final mandatory heart-failure model roster, ACC flags misclassification
- Jul 13, 2026 Mandatory Ambulatory Specialty Model forces cardiologists into two-sided risk starting January 2027
- Jul 19, 2026 CMS confirms mandatory Medicare risk model for heart failure cardiologists
- Jul 21, 2026 ACC finds up to 20 percent of cardiologists tapped for mandatory Medicare risk model may be misclassified
- Sep 1, 2026 CMS locks final mandatory heart-failure model roster, ACC flags misclassification
All issues grouped by day · newest first
Sunday, October 11 Week in review day
The Service LineWeek in review Two specialties, emergency medicine and pharmacy, ran this week, and both ended on the same question: who gets to set the number a clinician is paid? 7 stories 5 min Read → The LedgerWeek in review Hospitals went back to federal court Friday to stop a federal drug-discount rebate program they say would cost them more than $1 billion a year just to run. 5 stories 4 min Read → The RegulatorWeek in review The Food and Drug Administration (FDA) finalized a rule October 9 that lets food makers swap salt substitutes into 139 standardized foods, including breads and cheeses, without changing the food's legal name or recipe standard. 6 stories 5 min Read →
Saturday, October 10 3 editions
The Service Line5:30 PM Omnicare's Chapter 11 plan, confirmed September 17, is set to take effect this month, and the day it does CVS has two weeks to wire the first $130 million of a $440 million False Claims Act settlement. 5 stories 4 min Read → The Ledger12:30 PM Viatris, the generic and branded drugmaker, agreed October 8 to buy Pacira BioSciences, maker of the non-opioid pain drugs Exparel and Zilretta, for $36.50 a share in cash, an equity value of about $1.65 billion. 4 stories 5 min Read → The Regulator8:30 AM 20.8 million: that is the number of Original Medicare enrollees eligible for a one-time $90 Part B premium rebate that began reaching bank accounts around October 8, about $1.9 billion drawn from the Medicare Improvement Fund. 5 stories 4 min Read →
Friday, October 9 3 editions
The Service Line5:30 PM The Service Line issue for October 9, 2026. 6 stories 5 min Read → The Ledger12:30 PM Humana's stock jumped almost 13 percent after the closing bell Thursday and Alignment Healthcare's fell more than 20 percent, both because of one federal data release: the Centers for Medicare and Medicaid Services (CMS) 2027 Medicare Advantage Star Ratings, which decide how much quality bonus money each insurer collects in 2028. 5 stories 6 min 4 deals1 report Read → The Regulator8:30 AM 93 percent: that is the share of Humana Medicare Advantage plan members who will be enrolled in plans rated four stars or higher in 2027 after the Centers for Medicare and Medicaid Services (CMS) published its annual star ratings October 8, up from roughly 41 percent in 2026, a surge analysts project could translate to $3 billion or more in additional quality bonus payments in 2028. 6 stories 7 min Read →
Monday, September 28 1 edition
Sunday, September 27 Week in review day
The Service LineWeek in review This week's Service Line ran three specialty deep dives instead of the usual six. A publishing outage knocked Monday, Wednesday, and Friday off the schedule, and we would rather tell you that plainly than pretend the gap is not there. 6 stories 5 min Read → The LedgerWeek in review Eli Lilly is paying a Chinese biotech up to $3.35 billion for cancer and autoimmune drug targets that do not exist as products yet, and 97 percent of that number depends on trials that have not started. 4 stories 6 min Read → The RegulatorWeek in review The federal government named the first cohort of a new Medicare accountable care model this week, and once an existing accountable care organization (ACO) signs onto the model's highest-risk track, it cannot back out for the rest of the model's 10-year run. 6 stories 6 min Read →
Saturday, September 26 3 editions
The Service Line5:30 PM CMS published the formal follow-through to the meeting this newsletter covered two weeks ago, opening a request for information that asks the pharmacy industry to help write the actual definition of a "reasonable and relevant" Medicare Part D pharmacy contract. 5 stories 6 min Read → The Ledger12:30 PM Hospital AI tools found $942 million worth of conditions to code. Insurers say the care that should have followed those codes did not. 4 stories 7 min Read → The Regulator8:30 AM A federal court this week vacated the community integration provisions of HHS's Section 504 disability regulations, erasing the rules that told every provider receiving federal funding how to keep disabled patients out of nursing homes and in their communities, in a consent decree that applies in all 50 states. 6 stories 6 min Read →
Wednesday, September 23 1 edition
Tuesday, September 22 3 editions
The Service Line5:30 PM CMS put a number on nine months of cardiology's loudest coverage fight this week, and the multidisciplinary heart team survived it intact. 6 stories 6 min Read → The Ledger12:30 PM Forerunner Ventures is about to walk away from Oura with 1.2 billion dollars, and the ring maker itself will keep only a sliver of the money its own initial public offering raises. 4 stories 6 min Read → The Regulator8:30 AM A federal court deadline lands today in a fast-moving legal fight over how Medicare Advantage insurers earn hundreds of millions of dollars in federal quality bonus payments. 6 stories 7 min Read →
Monday, September 21 3 editions
The Ledger12:30 PM A radiopharmaceutical drug rejected by the Food and Drug Administration six weeks ago just became the trigger for one of the biggest deals nuclear medicine has ever seen. 5 stories 7 min 2 deals1 enforcement1 earnings1 record Read → The Regulator8:30 AM 246: that is the number of billions of dollars the federal government expects to cut from Medicaid spending over the next decade under a rule whose public comment period closes today. 5 stories 5 min Read → Catch-up Our publishing system was down September 19 and 20, 2026, so no Regulator or Ledger edition went out either day. This issue, written today, catches you up on that window. Every item below is dated to when it actually happened, and where this run found genuinely little to report, we are saying so plainly rather than padding the issue with stories that do not belong to these two days. 2 stories 3 min 1 alert Read →
Sunday, September 20 Outage
No editions published: publishing system outage. See the Sep 21 catch-up issue.
Saturday, September 19 Outage
No editions published: publishing system outage. See the Sep 21 catch-up issue.
Friday, September 18 1 edition
Thursday, September 17 1 edition
Wednesday, September 16 2 editions
The Ledger12:30 PM UPDATE: Sword Health just confirmed, in its own words, the Headspace acquisition this newsletter first flagged from a leaked regulatory filing seven weeks ago, and the confirmation comes with the deal's closing timeline pushed back. 4 stories 6 min Read → The Regulator8:30 AM Medicare's newest chronic care model just tripled the ground it covers, and about three in four people on Medicare now qualify for at least one track. 5 stories 5 min Read →
Tuesday, September 15 2 editions
The Ledger12:30 PM Addus HomeCare just made the healthcare sector's biggest disclosed-price acquisition of the week, buying its way into six new states for personal care services at the exact moment private equity's broader healthcare deal count is on pace for its lowest year since 2017. 4 stories 7 min Read → The Regulator8:30 AM 2.5: that is the percentage cut to Medicare's baseline physician payment rate for 2027 that just survived its public comment window, one day before the House committee that could reverse it held a hearing on how. 5 stories 6 min Read →
Saturday, September 12 3 editions
The Service Line5:30 PM This week, the Pharmacy Coalition, led by the National Community Pharmacists Association, met with CMS officials to discuss what "reasonable and relevant" contract terms should mean between pharmacy benefit managers and pharmacies in Medicare Part D networks. 5 stories 6 min Read → The Ledger12:30 PM A private equity duo just bought its way into the exact wearable-driven wellness platform built around the same technology now seeking a 16 billion dollar Wall Street debut. 5 stories 7 min 1 deal1 funding1 report2 records Read → The Regulator8:30 AM Illinois just became the first Midwestern state where doctors can prescribe life-ending medication to terminally ill adults, after a federal judge refused three days ago to block the law from taking effect today. 5 stories 5 min Read →
Friday, September 11 3 editions
The Service Line5:30 PM The Service Line issue for September 11, 2026. 6 stories 6 min Read → The Ledger12:30 PM UnitedHealth Group just sold a piece of the exact business that wrecked its earnings last year to a private equity firm, and Wall Street cannot decide if that is reassuring or alarming. 5 stories 8 min 4 deals1 record Read → The Regulator8:30 AM 22.2: that is the average percentage more Washington state residents who buy their own health insurance will pay in 2027, after a federal tax credit that used to cut $1,330 off the average yearly premium expired. 5 stories 6 min Read →
Thursday, September 10 3 editions
The Service Line5:30 PM Rochester Regional Health told expectant mothers in Wayne County, New York this month to plan on driving somewhere else to give birth, and a nationwide count published this summer shows the math behind that decision has become brutally consistent. 5 stories 6 min Read → The Ledger12:30 PM Three of the country's biggest for-profit hospital chains took the same investor conference stage this week and told three different stories about 2026. 4 stories 6 min 1 deal3 records Read → The Regulator8:30 AM 30: that is how many years in federal prison a Southern California pharmacy operator got this week for running nearly $270 million in fake claims through California's Medicaid program. 4 stories 4 min Read →
Wednesday, September 9 2 editions
The Ledger12:30 PM UnitedHealth Group's chief financial officer just told Wall Street the insurer's Medicare Advantage turnaround is beating plan, even as the company confirmed it will end 2026 with up to 1.1 million fewer Medicare Advantage members than it started with. 4 stories 6 min Read → The Regulator8:30 AM 11: that is how many medical equipment suppliers the government just barred from billing Medicare Advantage after finding more than $3.4 billion in suspected fraud, including bills submitted for patients who were already dead. 1 story 6 min Read →
Tuesday, September 8 2 editions
The Service Line5:30 PM Radiology Partners just closed the loop on an international ambition that collapsed a year ago, agreeing to buy Everlight Radiology and build the first true global teleradiology network out of the country's largest private-equity-backed radiology group. 6 stories 8 min Read → The Ledger12:30 PM 60 billion dollars: that is the federal Medicaid hospital funding nationwide that a new government tally says already exceeds Congress's incoming payment limits, and Texas hospitals are living the consequences first. 4 stories 7 min 1 deadline2 deals1 report Read →
Sunday, September 6 Week in review day
The LedgerWeek in review 27 million dollars a day: that is what Texas hospitals started losing in Medicaid funding this week, and a safety-net hospital CEO says the fallout would be "catastrophic." 4 stories 6 min 2 deals1 enforcement1 rule Read → The RegulatorWeek in review $1.6 billion: that is how much New York's insurance department says it saved residents and small businesses by cutting insurers' 2027 Affordable Care Act rate requests nearly in half, a fight playing out the same day in Delaware too. 6 stories 5 min 1 deadline1 enforcement2 rules2 approvals Read →
Saturday, September 5 3 editions
The Service Line5:30 PM Surgery Partners, the nation's largest publicly traded pure-play operator of ambulatory surgery centers (ASCs), posted a net loss that widened sixfold in the second quarter just as it walked back its acquisition target for the year, underscoring how expensive it has become to grow through deals even for the sector's biggest consolidator. 6 stories 8 min Read → The Ledger12:30 PM 209.5 million dollars: that is the cash sitting in a proteomics company's bank account, equal to 176 percent of its own stock market value, the reason activist investors demanded a board member resign this week. 3 stories 6 min 1 deal2 records Read → The Regulator8:30 AM 16: that is how many hospitals OhioHealth already runs, the health system federal antitrust regulators quietly pushed out of a deal for a rural Ohio hospital this week in favor of a smaller rival. 4 stories 4 min 1 deal1 enforcement1 alert1 funding Read →
Friday, September 4 2 editions
The Ledger12:30 PM 37 million dollars: that is the 2025 operating loss a financially distressed Ohio hospital had racked up when federal antitrust regulators intervened to reroute its sale, a merger that officially closed this week. 4 stories 6 min 3 deals1 report Read → The Regulator8:30 AM 290,000: that is how many Louisiana Medicaid enrollees just learned their health plan is leaving the program, the second state Medicaid exit by the same insurer in five weeks. 5 stories 5 min 2 rules1 funding2 records Read →
Wednesday, September 2 2 editions
The Ledger12:30 PM 9.8 billion dollars: that is Medtronic's revenue for its fiscal first quarter, a 13.7 percent jump that beat Wall Street and pushed the world's largest medical device maker to raise its full-year profit guidance. 4 stories 6 min 1 deal1 rule1 earnings1 record Read → The Regulator8:30 AM $19.6 billion: that is how much nine more pharmaceutical manufacturers just promised to invest in United States drug manufacturing, the price of joining a pricing program that now covers 89 percent of the branded drug market. 5 stories 5 min 1 deadline3 rules1 funding Read →
Tuesday, September 1 3 editions
The Service Line5:30 PM A sham-controlled trial found that catheter ablation for atrial fibrillation does not improve quality of life more than a fake procedure, a direct challenge to cardiology's fastest-growing procedure. 5 stories 5 min 1 deal2 rules1 report1 record Read → The Ledger12:30 PM 19.6 billion dollars: that is the new United States manufacturing commitment nine more drugmakers signed onto this week, in a drug pricing deal that now covers 89 percent of the branded drug market. 4 stories 6 min 3 deals1 rule Read → The Regulator8:30 AM 47: that is how many times Food and Drug Administration (FDA) inspectors documented microbial contamination at the German plant now driving a nationwide shortage of a chemotherapy drug that treats bone, soft tissue, and lymphoma cancers, many of them in children. 5 stories 6 min Read →
Monday, August 31 3 editions
The Service Line5:30 PM Private equity physician-practice deals are on pace to fall by half in 2026, and primary care is one of the specialties investors are pulling back from fastest. 5 stories 7 min 1 deal3 rules2 reports Read → The Ledger12:30 PM Up to 145 million dollars: that is what Teva Pharmaceuticals is paying for a bankrupt Connecticut drugmaker's entire neuroscience portfolio, in a deal struck the same week the company ran out of cash. 5 stories 8 min 4 deals1 record Read → The Regulator8:30 AM $1.6 billion: that is how much CMS says it has kept out of fraudsters' hands in Medicare lab billing since the Trump administration took office, using artificial intelligence to catch phantom test claims before they get paid. 6 stories 6 min 2 enforcement3 rules1 approval Read →
Friday, August 28 2 editions
The Ledger12:30 PM Up to 300 million dollars: that is what a digital physical-therapy company is paying, in cash, for a meditation app that investors once valued at 3 billion dollars. 4 stories 5 min 3 deals1 record Read → The Regulator8:30 AM $541.5 million: that is what a Florida physician group will pay in the largest healthcare fraud settlement the state has ever seen, after admitting it manipulated Medicare Advantage diagnosis codes for four straight years. 4 stories 5 min 1 enforcement1 funding2 reports Read →
Thursday, August 27 3 editions
The Service Line5:30 PM A for-profit hospital chain is turning a maternity ward into medical-surgical rooms, and a national report published the same month says that trade is now the norm, not the exception. 5 stories 7 min 1 rule4 reports2 records Read → The Ledger12:30 PM 3.9 billion dollars: that is the price tag on a hospital giant's ambulatory surgery center buyout that just cleared its last regulatory hurdle, at the cost of seven operating rooms in five cities. 6 stories 8 min 5 deals1 record Read → The Regulator8:30 AM $2 billion: that is how much in Medicaid funding the Trump administration has now deferred from California, citing "suspected fraud and noncompliance," as the state's hospice fraud crisis grinds into its second year. 7 stories 7 min 3 enforcement1 approval1 alert1 funding1 report Read →
Tuesday, August 25 2 editions
The Ledger12:30 PM 16: that is how many specialty pharmacies a behavioral-health pharmacy platform now runs, up from three, in the deal that just handed its private-equity backer an exit. 6 stories 8 min 6 deals Read → The Regulator8:30 AM $144 million: that is what 138 rural Alabama healthcare projects just split, the first payout from a federal program that is sending $50 billion to states over five years. 4 stories 4 min 2 enforcement1 funding1 report Read →
Monday, August 24 3 editions
The Service Line5:30 PM Medicare just proposed banning the outsourced staffing model that many chronic kidney disease monitoring programs run on, a rule change nephrology groups and their value based partners need to plan around before comments close September 14. 5 stories 6 min 2 rules1 earnings2 reports Read → The Ledger12:30 PM 2.3 billion dollars: that is the record-setting ceiling on a licensing deal Roche just signed for an obesity drug that has not entered a single Phase 2 trial. 5 stories 6 min 3 deals1 report1 record Read → The Regulator8:30 AM 25 percent: that is the highest share of Affordable Care Act marketplace prior authorization requests one insurer denied last year, in the first federal data set that lets patients compare denial rates insurer by insurer. 6 stories 6 min 2 enforcement2 rules1 report1 record Read →
Sunday, August 23 Week in review day
The LedgerWeek in review 435,000: that is how many people are about to lose their health insurer entirely, after a deal to save its Medicare Advantage business collapsed this week. 5 stories 6 min 2 deals1 report2 records Read → The RegulatorWeek in review Three: that is how many federal vaccine-recommendation categories the Department of Health and Human Services is now asking the public to help rewrite, a review whose outcome could determine which shots insurers must cover at zero cost to patients. 6 stories 7 min 2 deadlines2 enforcement1 rule1 alert Read →
Friday, August 21 2 editions
The Ledger12:30 PM 31.5 million dollars: that is what a Sunnyvale startup just raised to build a single procedure that images and treats the prostate, with one of the world's largest device makers as a new backer. 4 stories 5 min 4 deals Read → The Regulator8:30 AM Three: that is the number of everyday pieces of Medicare paperwork, an enrolled supplier number, a doctor's order, and a beneficiary's ID, that federal investigators say fraudsters have turned into a reliable formula for stealing durable medical equipment money from taxpayers. 5 stories 5 min 2 deadlines2 alerts1 report Read →
Thursday, August 20 1 edition
Wednesday, August 19 1 edition
Tuesday, August 18 1 edition
Sunday, August 16 Week in review day
Saturday, August 15 2 editions
The Ledger12:30 PM 10 percent: that is the median health care cost increase employers expect to face in 2027, the second year in a row benefits professionals have forecast a double digit jump, with weight loss drugs now the single biggest driver inside that number. 4 stories 6 min 1 deadline2 deals1 report Read → The Regulator8:30 AM 67 percent: that is the share of Medicare Advantage prior-authorization denials that get overturned when patients or doctors actually appeal them, the first insurer-by-insurer numbers a federal rule has ever forced into public view. 5 stories 6 min 2 enforcement2 rules1 report Read →
Thursday, August 13 2 editions
The Service Line5:30 PM MaineHealth's board confirmed on August 6 what its own numbers argued against, closing a labor and delivery unit that delivers 43 percent more babies than it did in 2019, and five days later a national report showed the closure is the rule, not the exception. 5 stories 6 min 1 enforcement1 rule3 reports1 record Read → The Regulator8:30 AM 208 million dollars: that is the restitution a fugitive Medicare fraudster agreed to repay after fleeing to the Philippines rather than face sentencing for a scheme prosecutors valued at $1.2 billion. 5 stories 6 min 3 enforcement1 alert1 report Read →
Wednesday, August 12 2 editions
The Ledger12:30 PM 475 million dollars: that is what a Zydus Lifesciences subsidiary could pay for a drug that has not finished a single Phase 3 trial, betting on a rare lung disease with no approved treatment anywhere in the United States. 5 stories 6 min 2 deals1 enforcement2 earnings Read → The Regulator8:30 AM 235 million dollars: that is the ten-year taxpayer savings CMS projects from a rule ending federal Medicaid and CHIP funding for gender-transition procedures in children, released yesterday and headed for the Federal Register tomorrow. 5 stories 5 min 1 enforcement3 rules1 alert Read →
Tuesday, August 11 3 editions
The Service Line5:30 PM RadNet, the country's largest publicly traded chain of outpatient imaging centers, posted 25 percent revenue growth in the second quarter of 2026 and just opened a new 250 million dollar credit line earmarked for more acquisitions, the clearest signal yet that the buyer market for independent radiology groups keeps getting more competitive. 6 stories 7 min 1 deal1 enforcement1 rule1 earnings1 approval1 report Read → The Ledger12:30 PM 1.32 billion dollars: that is what Jazz Pharmaceuticals is paying to buy a rare epilepsy drug that has never treated a single paying patient, the company's boldest bet yet on a genetic disorder no approved drug touches. 5 stories 7 min 5 deals Read → The Regulator8:30 AM 27.7 million dollars: that is how much prosecutors say a Los Angeles hospice operator and his marketer billed Medicare using the stolen identities of dead people, in a trial scheduled to open today. 6 stories 7 min 1 deadline1 enforcement3 rules1 alert Read →
Monday, August 10 2 editions
The Ledger12:30 PM 51.6 million dollars: that is the operating loss Tufts Medicine posted for the fiscal year that just closed, a dramatic improvement from a 214 million dollar loss the year before, and it is still enough for the health system's board to push out its chief executive and chief financial officer. 4 stories 5 min 1 deal1 earnings2 records Read → The Regulator8:30 AM 230 billion dollars: that is the fraud the White House says it has uncovered across federal programs since January 2025, and health care, not any other single sector, supplied the single biggest piece of the tally. 5 stories 5 min 2 enforcement2 rules1 report Read →
Sunday, August 9 Week in review day
The LedgerWeek in review 578 million dollars: that is what CommonSpirit Health lost from operations in a single quarter this year, the financial backdrop against which nurses at one of its Northern California hospitals picketed this week over plans to cut maternity and cancer-infusion staff. 4 stories 6 min 1 deal2 earnings1 record Read → The RegulatorWeek in review 28 patients: that is how many federal reviewers found may not yet have died when Kentucky's organ procurement organization began preparing them for donation, the finding behind only the second time the federal government has ever decertified an organ procurement organization (OPO). 5 stories 6 min 2 enforcement2 rules1 approval Read →
Friday, August 7 3 editions
The Service Line5:30 PM CMS finalized next year's hospice pay rule this week, and buried inside a routine rate update is the agency's most detailed public fraud-scoring system yet. 5 stories 6 min 1 deadline1 deal2 enforcement1 rule1 report1 record Read → The Ledger12:30 PM 81 percent: that is how far Doximity's stock jumped in a single session on a guidance raise built almost entirely on a product that has not booked a dollar of revenue yet. 6 stories 7 min 2 deals1 enforcement2 earnings1 record Read → The Regulator8:30 AM 15.2 million dollars: that is what Medicare improperly paid physicians for sacroiliac joint injections nationwide, after federal auditors found nearly three in four sampled sessions violated program rules, in a report where CMS refused to build the fix that would stop the biggest error going forward. 6 stories 6 min 4 rules1 report1 record Read →
Thursday, August 6 3 editions
The Service Line5:30 PM CMS just published the audit playbook every state will use on the fastest-growing benefit in behavioral health, and the growth curve behind it explains why. 6 stories 6 min 1 deadline1 deal1 enforcement1 rule2 reports Read → The Ledger12:30 PM 1.09 billion dollars: that is the operating income Oscar Health already banked in just the first half of 2026, more than its entire newly raised full-year guidance implies it will keep, meaning the insurer's own numbers point to a swing back to a loss in the second half. 6 stories 8 min 1 deal1 rule3 earnings1 record Read → The Regulator8:30 AM 2.1 billion dollars: that is how much more Medicare will pay the nation's hospitals next year, in a rule that also forces nearly every one of them into a single national experiment on hip, knee and ankle replacements. 6 stories 7 min 1 deal1 enforcement2 rules1 approval1 record Read →
Wednesday, August 5 3 editions
The Service Line5:30 PM 8 billion dollars: the price tag on the largest deal in radiopharmaceutical industry history, and it is a bet that targeted radiation, not chemotherapy, is where cancer treatment margin moves next. 4 stories 6 min 1 deal1 rule1 approval1 record Read → The Ledger12:30 PM 106.1 billion dollars: that is CVS Health's second quarter revenue, beating Wall Street by 6 billion dollars, and the stock still fell more than 6 percent. 5 stories 6 min 3 earnings1 report1 record Read → The Regulator8:30 AM 5.76 million dollars: that is how much prosecutors say Pennsylvania home-care aides and agencies billed Medicaid for schemes including one aide who kept billing while incarcerated, the debut case for a new Justice Department fraud unit permanently embedded in Philadelphia. 5 stories 6 min 1 enforcement2 rules1 alert1 report Read →
Tuesday, August 4 3 editions
The Service Line5:30 PM Cardiology's 2027 pay headline reads plus 1 percent. The line items underneath read like a cut. 5 stories 4 min 1 deadline1 enforcement3 rules2 reports Read → The Ledger12:30 PM 5.7 billion dollars: that is what KKR is paying to take the world's largest pure-play medical device contract manufacturer private, a 52 percent premium and the biggest healthcare buyout of the week. 5 stories 6 min 1 deal1 rule1 earnings1 approval1 record Read → The Regulator8:30 AM 14.1 million dollars: that is what a Jacksonville health-management company is paying the federal government for pushing doctors to add mental-health and addiction diagnoses that were not true, just to collect bigger Medicare Advantage checks. 6 stories 6 min Read →
Monday, August 3 3 editions
The Service Line5:30 PM CMS's two most recent report cards on its own ACO REACH model, published days apart in July, tell operators two different stories about the model roughly 115 accountable care organizations (ACOs) are being asked to decide whether to extend into a ten-year commitment. 5 stories 6 min 1 deal1 enforcement1 rule2 reports Read → The Ledger12:30 PM 8 billion dollars: that is the ceiling on a deal announced this morning that would combine two of the world's largest radiopharmaceutical makers, and Lantheus has already pulled its own 2026 outlook because of it. 4 stories 6 min 2 deals2 earnings Read → The Regulator8:30 AM 340 million dollars: that is how much more Medicare will pay the nation's inpatient rehabilitation hospitals next year, under a final rule the Centers for Medicare and Medicaid Services published in the Federal Register today. 6 stories 6 min 3 enforcement2 rules1 report Read →
Sunday, August 2 Week in review day
The LedgerWeek in review 38 percent: that is how much Dupixent's global sales jumped last quarter, pushing the eczema and asthma drug past 6 billion dollars in a single quarter for the first time, as Regeneron beat Wall Street on both the top and bottom line. 4 stories 6 min 2 deals1 earnings1 record Read → The RegulatorWeek in review 5 million: that is how many Americans HHS's own estimate says will lose Affordable Care Act marketplace coverage by 2030, under a rule 22 states sued to block this week. 6 stories 6 min 2 enforcement3 rules1 report Read →
Saturday, August 1 3 editions
The Service Line5:30 PM On July 14, 2026, the Federal Trade Commission finalized a settlement with CVS Health's Caremark Rx and its group purchasing arm Zinc Health Services, resolving the agency's administrative antitrust case alleging the PBM's rebate driven formulary design artificially inflated insulin list prices. 5 stories 6 min 1 deal2 enforcement1 rule1 report Read → The Ledger12:30 PM 1.5 billion dollars: that is what a Swiss plasma-therapeutics maker just locked in for its first-ever US factory, a deal that nearly died in a weeks-long fight over who pays for it. 5 stories 7 min 3 deals1 earnings1 report Read → The Regulator8:30 AM 330 million dollars: that is how much of the federal government's own appropriated budget for patient-safety research is sitting unspent, after the Trump administration quietly stopped funding the agency built to keep American health care safe. 5 stories 6 min 1 deadline1 enforcement2 rules1 report Read →
Friday, July 31 3 editions
The Service Line5:30 PM The federal government's $50 billion rural health fund is nudging hospitals to shrink their emergency departments instead of expanding them, with at least 25 states using it to rightsize. 5 stories 6 min 1 enforcement2 rules1 funding1 record Read → The Ledger12:30 PM 60,000 patients: that is how many UHealth patients keep their in-network access after a deal reached today ended a standoff this issue has tracked since July 27. 6 stories 9 min 2 rules3 reports1 record Read → The Regulator8:30 AM 60 million dollars: that is how much more Medicare will pay the nation's inpatient psychiatric hospitals next year, under a final rule the Centers for Medicare and Medicaid Services published in the Federal Register today, which also caps how much certain facilities can collect on their most expensive patients. 4 stories 5 min 1 deadline2 enforcement1 rule Read →
Thursday, July 30 3 editions
The Service Line5:30 PM A profitable rural Maine hospital is closing its maternity ward anyway, and the numbers show why "keep the volume, lose the delivery unit" is becoming the norm. 6 stories 6 min 1 deal1 enforcement2 rules1 report1 record Read → The Ledger12:30 PM 71.7 billion dollars: that is what Cigna took in last quarter, the health services giant's first earnings report under a new chief executive, and investors got a raised profit forecast to go with it. 6 stories 8 min 1 deadline2 deals3 earnings Read → The Regulator8:30 AM 26 states and the District of Columbia: that is the coalition of governments a federal judge told this week to keep preparing for Medicaid work requirements they wanted paused, five months before the rule takes effect nationwide. 6 stories 8 min 1 deadline2 enforcement2 rules1 record Read →
Wednesday, July 29 2 editions
The Ledger12:30 PM 1.84 dollars: that is how much Humana just cut its full year profit guidance floor, even after beating Wall Street's second quarter estimates, and the stock sold off anyway. 5 stories 7 min 1 deal2 earnings1 report1 record Read → The Regulator8:30 AM 3.6 billion dollars: that is the size of the Medicare drug-plan subsidy the Trump administration is letting expire after this year, a decision that will raise the standard 2027 premium for millions of beneficiaries with standalone prescription drug coverage. 5 stories 6 min 1 deadline1 deal1 enforcement2 rules Read →
Tuesday, July 28 3 editions
The Service Line5:30 PM Medicare has never had a standing way to pay for AI software as its own billable service, and CMS's newest hospital outpatient rule proposes creating one for the first time, with radiology and cardiac imaging AI tools making up most of the initial list. 6 stories 8 min 2 deals1 enforcement3 rules Read → The Ledger12:30 PM 1.09 billion dollars: that is the profit Centene posted this morning, a swing from a 253 million dollar loss a year ago, after the country's largest Medicaid managed-care insurer got its medical costs under control faster than Wall Street expected. 5 stories 7 min 1 deadline2 deals1 earnings1 report Read → The Regulator8:30 AM 2 p.m.: that is when a federal judge in Boston is scheduled to hear arguments today on whether the Trump administration illegally narrowed who counts as too medically frail to have to prove they are working to keep Medicaid. 3 stories 3 min 2 enforcement1 rule Read →
Monday, July 27 3 editions
The Service Line5:30 PM CMS just proposed raising the Medicare payment rate for dialysis treatments above $299 for the first time, while rewriting how facilities get paid extra for new drugs and home training. 6 stories 7 min 1 deal1 enforcement3 rules1 report Read → The Ledger12:30 PM 7.3 percent: that is how far Universal Health Services' stock fell within hours of beating Wall Street's second quarter revenue estimate, after the hospital and behavioral health operator cut its full year profit guidance. 5 stories 6 min 1 deadline3 deals1 earnings Read → The Regulator8:30 AM 8 provisions: that is how many pieces of a major Affordable Care Act marketplace rule a federal judge paused last week, days before they were set to reshape how millions of Americans buy 2027 health coverage. 5 stories 6 min 1 enforcement1 rule1 alert2 records Read →
Sunday, July 26 Week in review day
The LedgerWeek in review 5 days: that is how long University of Miami Health System and UnitedHealthcare have left to reach a new network contract before hundreds of thousands of patients go out of network. 5 stories 7 min 2 deals1 enforcement1 report1 record Read → The RegulatorWeek in review Two days: that is how long a federal judge in Massachusetts has before deciding whether to block a rule that narrows who counts as too medically frail to have to prove they are working to keep their Medicaid coverage. 6 stories 7 min 2 rules2 reports2 records Read →
Saturday, July 25 3 editions
The Service Line5:30 PM CMS just proposed adding roughly 618 new procedures to the list Medicare will pay ambulatory surgery centers (ASCs) to perform, the biggest single-year expansion of the ASC growth pipeline in years, while simultaneously choking off the pathway new devices use to get paid extra for using it. 6 stories 7 min 1 deal1 enforcement1 rule1 report2 records Read → The Ledger12:30 PM 416.2 million dollars: that is the record quarterly revenue a thermal management device maker posted this week, and it used the moment to announce a stock buyback nearly three times the size of its old one. 5 stories 7 min 1 deadline1 deal1 earnings1 report1 record Read → The Regulator8:30 AM Zero days: that is how much advance notice the Department of Health and Human Services gave hospitals and other federal grant recipients before a rule stripping a major category of civil-rights liability took effect this week. 5 stories 6 min 3 enforcement1 rule1 record Read →
Friday, July 24 3 editions
The Service Line5:30 PM Home-based care M&A volume just cratered, and dealmakers say the fraud crackdown is why. 6 stories 8 min 1 deal3 rules2 reports Read → The Ledger12:30 PM 6.12 dollars: that is the adjusted per share profit Tenet Healthcare posted for the second quarter, nearly 1.86 dollars above what Wall Street expected, and investors sent the stock up double digits within hours. 6 stories 8 min 3 earnings2 reports1 record Read → The Regulator8:30 AM 246 billion dollars: that is what the Centers for Medicare and Medicaid Services' own actuaries say a new Medicaid rule will cut from federal spending over the next decade, and the rule's public comment clock started running yesterday. 6 stories 6 min Read →
Thursday, July 23 3 editions
The Service Line5:30 PM CMS's proposed 2027 pay rule finishes a four-year psychotherapy pay raise and, in the same document, writes the newest telehealth in-person delay into regulation. 6 stories 6 min 1 deal1 enforcement2 rules1 funding1 report Read → The Ledger12:30 PM 2.28 billion dollars: that is the gap between what Wall Street expected Molina Healthcare to earn in 2026 and what the insurer actually guided to, and it wiped out an earnings beat within minutes of the numbers landing. 5 stories 7 min 2 deals2 earnings1 report Read → The Regulator8:30 AM A Senate committee capped insulin at 35 dollars a month for privately insured patients yesterday, and today it decides whether Robert F. Kennedy Jr.'s pick to run the Centers for Disease Control and Prevention survives committee. 5 stories 5 min 1 deadline1 enforcement1 rule1 alert1 record Read →
Wednesday, July 22 3 editions
The Service Line5:30 PM 68.5 percent of U.S. counties, home to 50.8 million people, had no radiation oncology practice site as of 2025, and the counties losing clinics skew rural, poorer and sicker than the ones keeping theirs. 5 stories 8 min 1 deal1 enforcement1 rule1 approval1 report Read → The Ledger12:30 PM 1.272 billion dollars: that is what a private equity buyer is paying to take medical device maker Avanos Medical private today, a 72 percent premium that shows what strategic buyers will pay for a company Wall Street had marked down. 4 stories 6 min 1 deadline2 deals1 enforcement Read → The Regulator8:30 AM 400 million dollars: that is what the Department of Justice agreed to pay Alaska's largest Native-run health system this week, after the federal government spent most of a decade shortchanging it on the cost of running its own health programs. 5 stories 6 min 1 enforcement1 rule3 reports Read →
Tuesday, July 21 3 editions
The Service Line5:30 PM Five of cardiology and cardiac surgery's biggest specialty societies told CMS this week that stripping the surgeon out of the room for Transcatheter Aortic Valve Replacement (TAVR) approvals goes too far, teeing up a fight before the government's September ruling. 6 stories 7 min 1 enforcement2 rules2 reports1 record Read → The Ledger12:30 PM Tempus AI agreed to pay 1.5 billion dollars for cancer-testing company Personalis, and Wall Street punished the buyer, not the seller, sending Tempus shares down as much as 8 percent. 4 stories 6 min Read → The Regulator8:30 AM 774.8 billion dollars: that is what the Centers for Medicare and Medicaid Services itself projects a Medicaid rule will save the government over the next decade, and today is the deadline for the public to weigh in before it can become final. 5 stories 5 min 1 enforcement1 rule1 alert1 funding1 record Read →
Monday, July 20 3 editions
The Service Line5:30 PM The Centers for Medicare and Medicaid Services (CMS) used its Calendar Year (CY) 2027 Physician Fee Schedule proposed rule, released July 14, to rewrite the math behind every Medicare Shared Savings Program (MSSP) accountable care organization's (ACO's) benchmark, the single biggest primary care policy event since the program's last major overhaul. 5 stories 6 min 1 deal1 enforcement3 rules Read → The Ledger12:30 PM Digital health investors funded fewer companies than dealmakers bought this spring, with 71 corporate acquisitions closing in the second quarter of 2026 alone, the busiest three months for digital health M&A since the height of the 2021 bull market. 4 stories 5 min 3 deals1 report Read → The Regulator8:30 AM The Centers for Medicare and Medicaid Services published draft guidance today spelling out how drug manufacturers must actually hand over Medicare's negotiated "maximum fair price" starting in 2028, the first time that mechanic has ever had to work for drugs doctors administer in their offices instead of ones patients pick up at a pharmacy. 6 stories 7 min 5 rules1 record Read →
Sunday, July 19 Week in review day
The Service LineWeek in review One CMS rulemaking season is now reshaping cardiology, radiology, orthopedics, and hospital medicine at the same time, and the throughline is where Medicare wants care to happen. 7 stories 8 min 6 rules Read → The LedgerWeek in review Intuitive Surgical beat Wall Street's second-quarter earnings estimates and its stock fell as much as 11 percent anyway, as investors focused on a slowdown in United States surgical procedure growth instead of the headline numbers. 4 stories 5 min 2 deals1 earnings1 report Read → The RegulatorWeek in review The Centers for Medicare and Medicaid Services proposed a rule that raises Medicare's shared savings rate for some accountable care organizations while retroactively imposing a new spending guardrail that delays those same organizations' 2025 reconciliation payments until November 2026. 6 stories 6 min 1 deadline2 enforcement1 rule1 approval1 report Read →
Saturday, July 18 3 editions
The Service Line5:30 PM The Consolidated Appropriations Act (CAA) of 2026, signed February 3, 2026, bars pharmacy benefit managers from earning any Part D compensation tied to a drug's price and requires 100 percent rebate pass-through to plan sponsors, replacing rebate-based pay with a flat "bona fide service fee" that PDP and MA-PD sponsors must enforce starting with the 2028 plan year. 5 stories 5 min 1 deal1 enforcement2 rules1 report Read → The Ledger12:30 PM An Israeli court will decide by July 19, 2026 whether InMode's board can keep negotiating a buyout led by its own chief executive, after activist investor Steel Partners sued to block the review over a rival, higher, all cash offer. 5 stories 6 min 4 deals1 report Read → The Regulator8:30 AM A federal judge blocked eight provisions of a Trump administration health insurance rule two business days before they were set to take effect, provisions the Centers for Medicare and Medicaid Services itself estimated could cost up to 2 million people their Affordable Care Act marketplace coverage. 7 stories 7 min 1 enforcement1 rule1 approval1 alert3 reports Read →
Friday, July 17 3 editions
The Service Line5:30 PM CMS's 2027 physician fee schedule pairs another pay cut with the first hospitalist-specific quality pathway, giving hospital medicine groups a reporting track built for them and three years to adopt it. 5 stories 4 min 1 deal1 enforcement4 rules Read → The Ledger12:30 PM Medtronic paid 650 million dollars in cash to complete its acquisition of SPR Therapeutics, adding an implant-free nerve stimulator for chronic pain to what the company calls the broadest pain-therapy portfolio in the industry. 4 stories 4 min 3 deals1 record Read → The Regulator8:30 AM CMS will let up to 12 percent of the nation's highest-performing nursing homes skip large parts of their federal inspection starting September 8, cutting survey time roughly in half for facilities that qualify. 6 stories 6 min 1 enforcement3 rules1 report1 record Read →
Thursday, July 16 2 editions
The Ledger12:30 PM UnitedHealth Group's second-quarter profit report beat Wall Street's estimate by roughly 30 percent and pushed its stock up as much as 8 percent, the clearest signal yet that the insurer's yearlong push to control medical costs is working. 4 stories 4 min 2 deals2 earnings Read → The Regulator8:30 AM A U.S. House committee voted 42-0 to force Medicare Advantage insurers to speed up and disclose their prior authorization decisions, one of seven bipartisan health bills the same committee advanced in a single markup. 6 stories 6 min 2 enforcement4 rules Read →
Wednesday, July 15 3 editions
The Service Line5:30 PM Atrium Health and OrthoCarolina built a new ambulatory surgery joint venture with no equity changing hands, a no-acquisition model other systems chasing orthopedic volume will study closely. 6 stories 4 min 2 deals2 enforcement1 rule1 report Read → The Ledger12:30 PM HCA Healthcare cut its full-year profit guidance after preliminary second-quarter results showed a bigger-than-expected hit from patients migrating out of Affordable Care Act marketplace plans, and its stock fell about 6.7 percent. 5 stories 7 min 2 enforcement2 earnings1 report Read → The Regulator8:30 AM CMS proposed cutting Medicare's physician payment rate for 2027, with most doctors facing a bigger cut than physicians in accountable care organizations, and the public has until September 14 to comment. 6 stories 6 min 1 deadline5 rules Read →
Tuesday, July 14 3 editions
The Service Line5:30 PM CMS wants to pay hospitals only 40 percent of the outpatient rate for basic CT, MRI, and ultrasound scans done at off-campus imaging sites, a direct shot at one of hospital imaging's most profitable corners. 6 stories 7 min 1 deal1 enforcement2 rules2 reports Read → The Ledger12:30 PM An Israeli court just froze InMode's board from deciding on a takeover fight, after the aesthetic-device maker's largest outside shareholder accused management of rigging the sale process in its own favor. 4 stories 5 min 2 deals2 reports Read → The Regulator8:30 AM The federal government's health care fraud watchdog told Congress this week that it recovered or saved 5.56 billion dollars from Medicare and Medicaid over just six months, a return of 12 dollars and 70 cents for every dollar Congress spends running the office. 5 stories 5 min 3 rules1 approval1 report Read →
Monday, July 13 3 editions
The Service Line5:30 PM CMS wants to strip cardiovascular procedures off Medicare's inpatient-only list starting in 2028, and its 2027 outpatient payment rule proposes doubling down on ambulatory surgery centers right now. 6 stories 7 min 1 enforcement3 rules2 reports Read → The Ledger12:30 PM A federal whistleblower lawsuit accuses Alignment Healthcare of manufacturing the Medicare Advantage insurer's first-ever profitable year, and the stock had its worst day in more than two years on the news. 5 stories 6 min 1 deal1 enforcement1 report2 records Read → The Regulator8:30 AM A federal Medicaid rule that controls billions of dollars in extra payments to hospitals and nursing homes hit a new compliance deadline this week, and a much bigger cut to that same pipeline is now eight days from closing its public comment window. 5 stories 5 min 2 enforcement2 rules1 approval Read →
Sunday, July 12 Week in review day
The LedgerWeek in review Memorial Hermann is shutting down its entire commercial health insurance business, the clearest sign yet that health systems are giving up on owning the payer side of the equation. 5 stories 5 min 2 deals1 report2 records Read → The RegulatorWeek in review A Los Angeles court permanently shut down the last operators of a fake health insurance scheme that took in payments from more than 14,000 Californians while keeping most of the money for itself. 6 stories 5 min 1 deadline2 enforcement3 rules Read →
Saturday, July 11 1 edition
Friday, July 10 1 edition
Wednesday, July 8 1 edition
Tuesday, July 7 1 edition
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