HHS decertifies Kentucky organ procurement organization over patient safety
Plus: Senate passes stopgap funding bill through December 11. The day's rules, money, and enforcement, sourced and tiered below.
American Health Intel
CMS finalizes FY2027 hospice pay rule, locks in SSVI fraud-scoring system
Plus: For-profit hospices run 167% higher non-hospice spending per day than nonprofits. The day's rules, money, and enforcement, sourced and tiered below.
Doximity stock jumps 81% on AI Search guidance raise
Plus: GoodRx beats and raises on Pharma Direct growth. The day's rules, money, and enforcement, sourced and tiered below.
OIG finds $15.2M improperly paid for sacroiliac joint injections, 72% noncompliance
Plus: FCC adopts Rural Health Care Program rate-justification waiver for 2027. The day's rules, money, and enforcement, sourced and tiered below.
CMS ABA toolkit for state Medicaid oversight, spending up 400% in four years
Plus: Medicare psychiatric hospital pay rises 2.2%, Colorado cuts behavioral Medicaid rates 2%. The day's rules, money, and enforcement, sourced and tiered below.
Oscar Health beats big, but its own guidance math implies a second-half loss
Plus: Privia Health grows Q2 revenue 21%, more than triples net income. The day's rules, money, and enforcement, sourced and tiered below.
Cardiology's 2027 Medicare pay update: plus 1 percent on paper, cuts underneath
Plus: A proposed 50 percent cut to same-day office visits would hit every cardiology practice. The day's rules, money, and enforcement, sourced and tiered below.
UPDATE: CMS's ACO REACH savings and evaluation numbers still disagree, LEAD decision pending
Plus: CMS details LEAD Model's capitated payment menu and 10-year risk commitment. The day's rules, money, and enforcement, sourced and tiered below.
CMS finalizes $2.1B hospital pay hike, mandatory nationwide joint-replacement bundle
Plus: Henderson NV doctor indicted in $95M Medicare wound-care fraud scheme. The day's rules, money, and enforcement, sourced and tiered below.
Curium to acquire Lantheus for up to $114.50/share, ~$8B, largest radiopharma deal ever
Plus: American Oncology Network now runs 9 radioligand therapy centers, up from 1 in 2023. The day's rules, money, and enforcement, sourced and tiered below.
CVS Health beats and raises, stock falls on 2027 headwinds
Plus: Eli Lilly Q2 revenue hits $23B on Mounjaro, Zepbound growth. The day's rules, money, and enforcement, sourced and tiered below.
DOJ opens permanent fraud strike-force office in Philadelphia
Plus: CMS releases autism therapy billing oversight toolkit for states. The day's rules, money, and enforcement, sourced and tiered below.