March 5, 2026 •
The 'PxDx' Algorithm: Automating Medical Necessity Denials The ‘PxDx’ system, formally known as “procedure-to-diagnosis,” represents a fundamental shift in how The Cigna Group processes medical…
February 26, 2026 •
The 2024 FTC Administrative Complaint: Core Allegations of Unfair Competition The Federal Trade Commission’s administrative complaint, filed on September 20, 2024, marked a decisive escalation…
February 22, 2026 • Ekalavya Hansaj
The NaviHealth Acquisition: Integrating AI into UnitedHealthcare's Denial Infrastructure In May 2020 UnitedHealth Group completed a strategic maneuver that fundamentally altered the mechanics of Medicare…
February 8, 2026 • Ekalavya Hansaj
Federal Kickback Probe: The DOJ Lawsuit on Medicare Advantage Broker Schemes Federal Kickback Probe: The DOJ Lawsuit on Medicare Advantage Broker Schemes ### The Pay-to-Play…
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