In his latest column, President and CEO Dr. Drew Altman asks if prior authorization review could be eliminated entirely, discussing how it might be done and the tradeoffs. He writes “Nothing makes American health care consumers more frustrated using the health system than prior authorization review. I know because they told us that, ranking prior authorization review far ahead of any other problems they have getting care and navigating the health care system, including getting appointments and understanding their bills.”

CMS has recently announced a new approach to fraud that will rely more heavily on options to pause or withhold significant amounts of federal funding in cases of potential fraud, which could have broad implications for states and enrollees. This issue brief explains the new approach.

The Administration’s latest funding deadline and guidance shift intensifies pressure to the reproductive health safety net at a time when the number of uninsured individuals is projected to rise due to Medicaid cuts and expiration of enhanced Affordable Care Act premium tax credits, and Planned Parenthood clinics have lost their federal Medicaid funding.

The EPA launched the next step of its fluoride safety review, as more states move to ban community water fluoridation and senior officials amplify concerns about fluoride beyond what current evidence supports. The Monitor also explores AI policy and content moderation, including the practice of GEO to influence what AI chatbots say.

CMS’s efforts to expand Medicare coverage of GLP-1s for obesity could provide substantial benefits to millions of Medicare beneficiaries, given the potential demand for these highly effective medications…There are potential drawbacks to the short-term program, however.