Healthcare Policy

Launch of AI Agents for Chart Retrieval and HEDIS Coding

Automated coding tools are moving into risk adjustment workflows to reduce administrative overhead in CMS audits.

HTI-5 Rule Targets AI Agents for Information Blocking Enforcement

Health systems using automated scheduling or triage bots must ensure these tools do not inadvertently create data sharing barriers.

Clinical AI Facing Payer Reimbursement Battle in 2026

Adoption will rely on proving direct cost-savings as payers resist adding broad fee-for-service codes for AI-enabled diagnostics.

Sanofi acquired Dynavax to expand its portfolio with a hepatitis B vaccine and shingles candidate.

AbbVie signed a $100M upfront deal ($1.07B milestones) for a trispecific T-cell binder targeting small cell lung cancer.

Ultragenyx initiated major cost-cutting after two Phase 3 trials for its bone disease drug failed, causing shares to drop 43%.

California DHCS and CMS allocated $140M for a statewide partnership with Innovaccer to unify care for 2 million Medi-Cal patients.

HHS plans significant budget reductions for Medicaid and SNAP, potentially stripping benefits from millions. Health plans are already scaling outreach to manage this churn.

Enforcement of accessibility standards for medical equipment and the legalization of medical aid in dying in 12 states will require operational adjustments for health systems.

Following Senator Sanders' block of pediatric PRV reauthorization, drug developers must monitor for a replacement incentive program to support rare disease pipelines.