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US Observational Data Show Variable Real-World Outcomes With JAK Inhibitors in RA
01/19/2026
Juliet Gallagher
Real-world evidence (RWE) is increasingly used to complement randomized controlled trial data in rheumatoid arthritis treatment decision-making. A new study synthesized observational studies evaluating the real-world effectiveness of Janus...
Real-world evidence (RWE) is increasingly used to complement randomized controlled trial data in rheumatoid arthritis treatment decision-making. A new study synthesized observational studies evaluating the real-world effectiveness of Janus...
Real-world evidence (RWE) is...
01/19/2026
First Report Managed Care
News
Miami Drug Wholesaler Enters Federal Opioid Deferred Prosecution Agreement
01/14/2026
Hannah Musick
A Miami pharmaceutical wholesaler admitted to knowingly supplying millions of opioid pills to Houston-area pill mill pharmacies under a federal deferred prosecution agreement, highlighting continued enforcement against opioid diversion across...
A Miami pharmaceutical wholesaler admitted to knowingly supplying millions of opioid pills to Houston-area pill mill pharmacies under a federal deferred prosecution agreement, highlighting continued enforcement against opioid diversion across...
A Miami pharmaceutical...
01/14/2026
First Report Managed Care
News
DEA Extends Telemedicine Flexibilities for Prescribing Controlled Medications Through 2026
01/13/2026
Danielle Sposato
The Drug Enforcement Administration (DEA), jointly with the Department of Health and Human Services (HHS), has issued a Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for the Prescription of Controlled Medications. The...
The Drug Enforcement Administration (DEA), jointly with the Department of Health and Human Services (HHS), has issued a Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for the Prescription of Controlled Medications. The...
The Drug Enforcement...
01/13/2026
First Report Managed Care
News
House Passes Bill to Extend ACA Premium Tax Credits
01/13/2026
Hannah Musick
The US House has advanced a bipartisan-backed bill to extend enhanced Affordable Care Act (ACA) premium tax credits, setting up a high-stakes Senate debate with major implications for insurance affordability and patient access to care.
The US House has advanced a bipartisan-backed bill to extend enhanced Affordable Care Act (ACA) premium tax credits, setting up a high-stakes Senate debate with major implications for insurance affordability and patient access to care.
The US House has advanced a...
01/13/2026
First Report Managed Care
News
Specialist Access Eliminates Racial Gaps in Rheumatoid Arthritis DMARD Use
01/12/2026
Lisa Kuhns, PhD, MD
Racial inequities in access to modern rheumatoid arthritis (RA) therapies persist across the United States, but disappear among patients who reach rheumatology care, according to study results published in The Journal of Rheumatology.
Racial inequities in access to modern rheumatoid arthritis (RA) therapies persist across the United States, but disappear among patients who reach rheumatology care, according to study results published in The Journal of Rheumatology.
Racial inequities in access to...
01/12/2026
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
News
HHS Revises Childcare Payment Rules, Restoring Attendance-Based Billing
01/05/2026
Hannah Musick
HHS announced it will roll back childcare payment rules, restore attendance-based billing, and revise oversight requirements for federally funded programs.
HHS announced it will roll back childcare payment rules, restore attendance-based billing, and revise oversight requirements for federally funded programs.
HHS announced it will roll back...
01/05/2026
First Report Managed Care
News
AI Navigator Launched to Support Medicaid and SNAP Members Amid Policy Shifts
12/22/2025
Hannah Musick
Social health platform Pyx Health has launched an AI-driven navigator aimed at helping US Medicaid and Supplemental Nutrition Assistance Program (SNAP) beneficiaries comply with new policy requirements under the One Big Beautiful Bill Act...
Social health platform Pyx Health has launched an AI-driven navigator aimed at helping US Medicaid and Supplemental Nutrition Assistance Program (SNAP) beneficiaries comply with new policy requirements under the One Big Beautiful Bill Act...
Social health platform Pyx...
12/22/2025
First Report Managed Care
News
CMS Unveils LEAD Model to Succeed ACO REACH in 2027
12/19/2025
Grace Taylor, MS, MA
The Centers for Medicare & Medicaid Services (CMS) is set to replace the Accountable Care Organization (ACO) REACH model with its longest-ever accountable care demonstration, a 10-year Long-Term Enhanced ACO Design (LEAD) model aimed at...
The Centers for Medicare & Medicaid Services (CMS) is set to replace the Accountable Care Organization (ACO) REACH model with its longest-ever accountable care demonstration, a 10-year Long-Term Enhanced ACO Design (LEAD) model aimed at...
The Centers for Medicare &...
12/19/2025
First Report Managed Care
News
Rising Denials and Payer Audits Intensify Financial Strain on Hospitals in 2025
12/16/2025
Lisa Kuhns, PhD, MD
Hospitals are facing rising financial pressure as denial amounts and payer audits continue to climb in 2025, signaling an unsustainable trend for many health systems, according to a new report from billing compliance and revenue integrity...
Hospitals are facing rising financial pressure as denial amounts and payer audits continue to climb in 2025, signaling an unsustainable trend for many health systems, according to a new report from billing compliance and revenue integrity...
Hospitals are facing rising...
12/16/2025
First Report Managed Care

Behind the Bill

Behind the Bill
The Senate’s $3 Trillion Deal. Tax Relief Now, Medicaid Coverage Loss Later?
07/02/2025
Katie Hayes, MJ
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After...
07/02/2025
First Report Managed Care
Behind the Bill
When a Cap Isn’t Just a Cap: How a Provider Tax Proposal Could Reshape Medicaid Financing
06/25/2025
Katie Hayes, MJ
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most...
06/25/2025
First Report Managed Care
Behind the Bill
Rewriting the Safety Net? Inside the Senate’s Changes to Medicaid and the ACA
06/18/2025
Katie Hayes, MJ
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve...
06/18/2025
First Report Managed Care
Behind the Bill
How States Might Respond to the One Big Beautiful Bill Act
06/11/2025
Katie Hayes, MJ
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill...
06/11/2025
First Report Managed Care
Behind the Bill
Is the Affordable Care Act on the Chopping Block? What the One Big Beautiful Bill Act Tells Us.
06/04/2025
Katie Hayes, MJ
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of...
06/04/2025
First Report Managed Care
Behind the Bill
From House to Senate: The Journey of Cutting Medicaid
05/28/2025
Katie Hayes, MJ
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of...
05/28/2025
First Report Managed Care
Behind the Bill
Eligibility, Paperwork, and Penalties: The Not-So-Hidden Costs of Medicaid ‘Reform’
05/21/2025
Katie Hayes, MJ
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week...
05/21/2025
First Report Managed Care
Behind the Bill
A Busy Week in Drug Pricing Policy: Aligning US Drug Prices With Global Standards?
05/14/2025
Katie Hayes, MJ
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for...
05/14/2025
First Report Managed Care
BEHIND THE BILL
When Agencies Lose Power: How 3 Seismic Shifts are Transforming Pharmaceutical Regulation
05/07/2025
Katie Hayes, MJ
In the span of just 9 months, the landscape of administrative law has undergone a transformation so profound that pharmaceutical executives, health care providers, and patients alike are struggling to navigate the new terrain. The Supreme...
In the span of just 9 months, the landscape of administrative law has undergone a transformation so profound that pharmaceutical executives, health care providers, and patients alike are struggling to navigate the new terrain. The Supreme...
In the span of just 9 months,...
05/07/2025
First Report Managed Care
Behind the Bill
The Medicare Paradox, Part 3: Strategic Trade Doesn’t Have to be a Zero-Sum Game
05/07/2025
Katie Hayes, MJ
Over the past 2 weeks, I’ve examined the growing friction between the Section 232 pharmaceutical tariff investigations and the Medicare drug pricing reforms authorized by the Inflation Reduction Act (IRA). These 2 policy agendas—industrial...
Over the past 2 weeks, I’ve examined the growing friction between the Section 232 pharmaceutical tariff investigations and the Medicare drug pricing reforms authorized by the Inflation Reduction Act (IRA). These 2 policy agendas—industrial...
Over the past 2 weeks, I’ve...
05/07/2025
First Report Managed Care

Trending Articles

Shomali Podcast
Podcasts
Expanding Diabetes Care
02/27/2024

Featuring Mansur Shomali, MD, chief medical officer at Welldoc, endocrinologist at MedStar Health 

Featuring Mansur Shomali, MD, ch...
Discover how digital therapeutics are revolutionizing disease management, patient care, reducing health care costs, and more with Dr Mansur Shomali, CMO at Welldoc.
Discover how digital therapeutics are revolutionizing disease management, patient care, reducing health care costs, and more with Dr Mansur Shomali, CMO at Welldoc.
Discover how digital...
02/27/2024
First Report Managed Care
News
Increased Scrutiny of Prior Authorization: Are Payers Fully to Blame, and Can AI Improve the Process?
04/05/2024
Dean Celia
The increased scrutiny of prior authorization, highlighted by media reports and government actions, prompts debate over payer responsibility while exploring the potential for AI to enhance the process.
The increased scrutiny of prior authorization, highlighted by media reports and government actions, prompts debate over payer responsibility while exploring the potential for AI to enhance the process.
The increased scrutiny of prior...
04/05/2024
First Report Managed Care
Anne Headshot
Commentary
Long-Term, High-Impact Nursing Care Solutions Promote High-Value Care
05/06/2024
It's no secret that nursing is in a state of crisis. From the onset of the COVID-19 pandemic to now, nurses nationwide have increasingly battled rising burnout and stress–all while caring for higher-acuity patients, with less support. Anne...
It's no secret that nursing is in a state of crisis. From the onset of the COVID-19 pandemic to now, nurses nationwide have increasingly battled rising burnout and stress–all while caring for higher-acuity patients, with less support. Anne...
It's no secret that nursing is...
05/06/2024
First Report Managed Care
News
Increased Understanding of Rosacea Pathogenesis Leads to An Increase in Therapeutic Options
05/30/2024
Lisa Kuhns, PhD, MD
Rosacea imposes a substantial burden on both patients and the economy, and further research is needed to better understand its pathogenesis and develop new treatments, according to an article published in Frontiers in Medicine.
Rosacea imposes a substantial burden on both patients and the economy, and further research is needed to better understand its pathogenesis and develop new treatments, according to an article published in Frontiers in Medicine.
Rosacea imposes a substantial...
05/30/2024
First Report Managed Care
Infographic thumbnail
Timeline of Key IRA Milestones
07/15/2024
Katie Hayes, MJ
As we approach the 2-year anniversary of the enactment of the Inflation Reduction Act, let's take a look at key upcoming milestones.
As we approach the 2-year anniversary of the enactment of the Inflation Reduction Act, let's take a look at key upcoming milestones.
As we approach the 2-year...
07/15/2024
First Report Managed Care

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