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News
Aetna Reaches $117.7M Settlement in False Claims Act Violation
03/11/2026
Danielle Sposato
Aetna Inc. has agreed to pay $117.7 million to resolve allegations that it violated the False Claims Act by submitting or failing to withdraw inaccurate diagnosis codes for Medicare Advantage (MA) enrollees, resulting in inflated payments...
Aetna Inc. has agreed to pay $117.7 million to resolve allegations that it violated the False Claims Act by submitting or failing to withdraw inaccurate diagnosis codes for Medicare Advantage (MA) enrollees, resulting in inflated payments...
Aetna Inc. has agreed to pay...
03/11/2026
First Report Managed Care
News
TrumpRx.gov Launch Targets Lower Prescription Drug Prices in United States
02/06/2026
Juliet Gallagher
The Trump Administration has announced the launch of TrumpRx.gov, a new website designed to provide American patients with access to prescription drug prices aligned with the lowest paid in other developed nations. The initiative applies...
The Trump Administration has announced the launch of TrumpRx.gov, a new website designed to provide American patients with access to prescription drug prices aligned with the lowest paid in other developed nations. The initiative applies...
The Trump Administration has...
02/06/2026
First Report Managed Care
Yuri Fesko, MD, PAMA, Health Care Policy, Medicare
Interview
PAMA and the Downstream Impact of Lab Reimbursement on Cancer Care Access
01/22/2026
Yuri Fesko, MD
In this interview, senior vice president and chief medical officer at Quest Diagnostics, Yuri Fesko, MD, discusses how Medicare laboratory reimbursement under PAMA threatens access to precision cancer diagnostics—particularly for rural and...
In this interview, senior vice president and chief medical officer at Quest Diagnostics, Yuri Fesko, MD, discusses how Medicare laboratory reimbursement under PAMA threatens access to precision cancer diagnostics—particularly for rural and...
In this interview, senior vice...
01/22/2026
First Report Managed Care
News
CMS Establishes Office of Rural Health Transformation Nationwide
01/09/2026
Grace Taylor, MS, MA
The Centers for Medicare & Medicaid Services (CMS) has formally launched the Office of Rural Health Transformation, creating a dedicated hub to oversee a $50 billion, 5-year effort to strengthen rural health systems and expand access to care...
The Centers for Medicare & Medicaid Services (CMS) has formally launched the Office of Rural Health Transformation, creating a dedicated hub to oversee a $50 billion, 5-year effort to strengthen rural health systems and expand access to care...
The Centers for Medicare &...
01/09/2026
First Report Managed Care
Ashis Kumar Das, MD
Interview
How the IRA Is Reshaping Drug Evaluation Through Medicare-Focused Real-World Evidence
12/04/2025
Ashis Kumar Das, PhD, MD, MPH
Discover how the Inflation Reduction Act (IRA) is transforming drug value assessment as Ashis Das, MD, PhD, breaks down what the Centers for Medicare & Medicaid Services (CMS) expects from manufacturers in today’s Medicare landscape.
Discover how the Inflation Reduction Act (IRA) is transforming drug value assessment as Ashis Das, MD, PhD, breaks down what the Centers for Medicare & Medicaid Services (CMS) expects from manufacturers in today’s Medicare landscape.
Discover how the Inflation...
12/04/2025
First Report Managed Care
Brandes Headshot
Interview
Navigating Medicaid Turbulence: What Community Providers Need to Know
12/01/2025
Jeff Brandes
Jeff Brandes discusses the national impact of Medicaid cuts, the administrative challenges forcing eligible patients off coverage, and the mounting strain on safety-net clinics.
Jeff Brandes discusses the national impact of Medicaid cuts, the administrative challenges forcing eligible patients off coverage, and the mounting strain on safety-net clinics.
Jeff Brandes discusses the...
12/01/2025
First Report Managed Care
News
NIH Oversight Gaps Raise Fraud Risks in $1.9B Other Transaction Portfolio
11/26/2025
Juliet Gallagher
A new report from the Office of Inspector General (OIG) warns that gaps in NIH oversight have heightened fraud, waste, and abuse risks across its Other Transaction (OT) awards. The findings come amid a rapid expansion of OT use—from under...
A new report from the Office of Inspector General (OIG) warns that gaps in NIH oversight have heightened fraud, waste, and abuse risks across its Other Transaction (OT) awards. The findings come amid a rapid expansion of OT use—from under...
A new report from the Office of...
11/26/2025
First Report Managed Care
News
Independent Dispute Resolution Abuse Threatens No Surprise Act’s Success and Drives Up System Costs
11/25/2025
Lisa Kuhns, PhD, MD
The No Surprises Act (NSA) is shielding Americans from nearly 20 million surprise medical bills each year, but the federal arbitration system intended to resolve payment disputes is being overwhelmed and undermined by large volumes of...
The No Surprises Act (NSA) is shielding Americans from nearly 20 million surprise medical bills each year, but the federal arbitration system intended to resolve payment disputes is being overwhelmed and undermined by large volumes of...
The No Surprises Act (NSA) is...
11/25/2025
First Report Managed Care
News
CMS Finalizes 2026 Rule to Strengthen Hospital Price Transparency Nationwide
11/24/2025
Grace Taylor, MS, MA
The Centers for Medicare & Medicaid Services (CMS) has finalized new 2026 hospital price transparency rules requiring hospitals nationwide to publish verified, standardized pricing data to empower patients and payers with clearer cost...
The Centers for Medicare & Medicaid Services (CMS) has finalized new 2026 hospital price transparency rules requiring hospitals nationwide to publish verified, standardized pricing data to empower patients and payers with clearer cost...
The Centers for Medicare &...
11/24/2025
First Report Managed Care
Videos
Obesity Drugs for Medicare: What the GLP-1 Pricing Agreement Means for Access
11/20/2025
Adam Colborn, JD
Adam Colborn, JD, associate vice president for congressional affairs at the Academy of Managed Care Pharmacy, discusses how the Trump administration’s “most favored nation” drug-pricing agreements test the limits of executive authority,...
Adam Colborn, JD, associate vice president for congressional affairs at the Academy of Managed Care Pharmacy, discusses how the Trump administration’s “most favored nation” drug-pricing agreements test the limits of executive authority,...
Adam Colborn, JD, associate vice...
11/20/2025
First Report Managed Care

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