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Trump Administration Proposes Expanded Transparency in Coverage Requirements for Health Plans

December 24, 2025

Last week, we released an Industry Watch Alert analyzing Governor Ron DeSantis’ proposal for a Florida Artificial Intelligence Bill of Rights. That alert highlighted several operational implications for payers and utilization management organizations, including the growing importance of human oversight in claims workflows, oversight of AI enabled vendors, and heightened risk in behavioral health applications.

Only a few days later (on December 11, 2025), President Donald J. Trump issued a federal executive order titled Ensuring a National Policy Framework for Artificial Intelligence. The order promotes a single national standard for AI governance and directs federal agencies to challenge state laws that conflict with that standard. It also announces the creation of a Department of Justice AI Litigation Task Force.

The executive order has generated significant discussion and speculation. This alert focuses strictly on information from official sources, and any additional context from news reporting is clearly identified as such.

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CMS Proposes Mandatory Medicare Part B Drug Payment Model Using International Price Benchmarks

December 22, 2025

Last week, we released an Industry Watch Alert analyzing Governor Ron DeSantis’ proposal for a Florida Artificial Intelligence Bill of Rights. That alert highlighted several operational implications for payers and utilization management organizations, including the growing importance of human oversight in claims workflows, oversight of AI enabled vendors, and heightened risk in behavioral health applications.

Only a few days later (on December 11, 2025), President Donald J. Trump issued a federal executive order titled Ensuring a National Policy Framework for Artificial Intelligence. The order promotes a single national standard for AI governance and directs federal agencies to challenge state laws that conflict with that standard. It also announces the creation of a Department of Justice AI Litigation Task Force.

The executive order has generated significant discussion and speculation. This alert focuses strictly on information from official sources, and any additional context from news reporting is clearly identified as such.

Read More »
A robot hand reaching out to touch a human hand

Trump Executive Order Seeks To Limit State AI Laws

December 16, 2025

Last week, we released an Industry Watch Alert analyzing Governor Ron DeSantis’ proposal for a Florida Artificial Intelligence Bill of Rights. That alert highlighted several operational implications for payers and utilization management organizations, including the growing importance of human oversight in claims workflows, oversight of AI enabled vendors, and heightened risk in behavioral health applications.

Only a few days later (on December 11, 2025), President Donald J. Trump issued a federal executive order titled Ensuring a National Policy Framework for Artificial Intelligence. The order promotes a single national standard for AI governance and directs federal agencies to challenge state laws that conflict with that standard. It also announces the creation of a Department of Justice AI Litigation Task Force.

The executive order has generated significant discussion and speculation. This alert focuses strictly on information from official sources, and any additional context from news reporting is clearly identified as such.

Read More »

Imaging AI Moves Toward Routine Use in Emergency Care

November 26, 2025

Imaging AI is moving into routine emergency care. Avicenna.AI and Ferrum Health formed a nationwide partnership that expands access to AI-supported CT tools for stroke, PE, trauma, and spine cases. Learn how this development affects payer costs, utilization trends, UM workflows, and independent external review.

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Front of the White House

Legislation Introduced to Block CMS WISeR Model

November 13, 2025

A bipartisan group of U.S. House members has introduced legislation to stop the Centers for Medicare & Medicaid Services (CMS) from implementing the Wasteful and Inappropriate Services Reduction (WISeR) Model, a six-year demonstration scheduled to begin January 1, 2026.

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CMS Announces Vendor List for WISeR Model

November 9, 2025

The Centers for Medicare & Medicaid Services (CMS) has named six vendor participants for the Wasteful and Inappropriate Service Reduction (WISeR) Model, set to launch January 1, 2026. These organizations will partner with Medicare Administrative Contractors (MACs) to conduct technology-enhanced prior authorization and pre-payment medical reviews in selected states.

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Updates on CMS WISeR Model – Launch & Key Pilot Facts

October 30, 2025

The Centers for Medicare & Medicaid Services (CMS) will implement the Wasteful and Inappropriate Service Reduction (WISeR) Model beginning January 1, 2026, through December 31, 2031. This pilot applies to Original Medicare only, not Medicare Advantage, and operates in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.

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FDA Awards First-Ever National Priority Vouchers

FDA Awards First-Ever National Priority Vouchers

October 22, 2025

The U.S. Food and Drug Administration (FDA) has awarded the first-ever National Priority (NP) Vouchers to nine sponsors as part of its new Commissioner’s National Priority Voucher (CNPV) Pilot Program. These vouchers provide priority review for future submissions, supporting the rapid advancement of treatments in areas of public health importance such as antimicrobial resistance, rare diseases, and domestic manufacturing resilience.

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