UnitedHealthcare to publish annual update to Gold Card program on September 1

What You Need to Know: UnitedHealthcare will release its annual update to the national Gold Card program on September 1, 2025. Physicians should check their status in provider portal promptly, as disputes must be filed by September 30, 2025.



UnitedHealthcare (UHC) will publish its annual updated list of practices that qualify for the national UHC Gold Card program on September 1, 2025. Effective October 1, practices granted Gold Card status, will be exempt from the certain UHC prior authorization requirements, though they will still need to advance notification process. More...

White House releases AI action plan with focus on health care

The White House recently unveiled its artificial intelligence (AI) action plan identifying more than 90 recommended changes in federal policy that the administration will pursue in the coming weeks and months. The plan is built on three pillars: accelerating innovation, building AI infrastructure, and leading in international diplomacy and security.

The administration emphasized its commitment to the responsible development and deployment of augmented intelligence – often called artificial intelligence – to improve health outcomes. More...

Anthem now enforcing gestational age reporting for maternity claims

Anthem Blue Cross recently began enforcing a maternity claims policy that is creating significant administrative and financial burdens for physicians. The policy outlined in the Anthem California Facility and Professional Provider Manual, requires physicians to report the gestational age at delivery on all professional maternity claims by including the appropriate ICD-10 Z3A diagnosis code. Many practices—unaware of the requirement—are now receiving repayment demands on previously paid claims, triggering time-intensive dispute resolution, re-billing and payment reconciliation work. More...

White House and tech leaders pledge a new patient-centric health tech ecosystem

During a “Make Health Tech Great Again” event last month, the White House announced the launch of a health tech ecosystem initiative intended to improve health care interoperability and develop more user-friendly apps for consumers. 

The initiative includes a voluntary commitment from more than 60 health care providers, health plans, and tech companies to develop new consumer-facing tools to improve interoperability and health data-sharing. More...

Understanding the MultiPlan antitrust case – find out if your practice qualifies

A sweeping federal antitrust case against MultiPlan, Inc. and several major payors is moving forward after a significant win for plaintiffs in June. The MultiPlan multidistrict litigation (MDL No. 3121), pending before Judge Matthew F. Kennelly in the Northern District of Illinois, alleges that MultiPlan and other major insurers including Aetna, Cigna, UnitedHealth, and Blue Cross Blue Shield conspired to systematically underpay out-of-network health care providers through price-fixing and other anticompetitive practices. More...

CAP's Case of the Month

Who Holds the Power When a Patient Can’t Decide?

When a patient loses capacity, who truly holds the power to decide their care? A recent court ruling underscores the strength of advance directives—read CAP's Case of the Month to see why this matters for your practice and your patients.

In 2013, L.A.C. executed an advance directive stating she did not want her life extended by artificially administered nutrition and hydration. After losing capacity seven years later, L.A.C.’s sister and adult children filed competing actions to appoint a guardian for her in 2021. More...

One wrinkle to surprise billing law? Health plans aren’t paying up

What’s the news: The AMA is backing recently introduced bipartisan legislation to help address shortcomings in the independent-resolution process established under the 2020 No Surprises Act.

The legislation—called the No Surprises Act Enforcement Act (H.R. 4710; S. 2420)—was introduced in late July by Sens. Roger Marshall, MD (R-Kan.) and Michael Bennet (D-Colo.) and Reps. Greg Murphy, MD (R-N.C.), Kim Schrier, MD (D-Wash.), John Joyce, MD (R-Pa.), Jimmy Panetta (D-Calif.), Bob Onder, MD (R-Mo.), and Raul Ruiz, MD (D-Calif.).

The measure comes in response to reports that many health plans fail to adhere to statutory timelines for payment after an independent-dispute resolution entity has made a final and binding determination, and the bill would allow penalties on parties that don’t pay up. If enacted, the measure would help enforce independent-dispute resolution decisions and reestablish the balance achieved in the No Surprises Act. The legislation also imposes additional reporting requirements on the governmental agencies charged with enforcement of the statute. More...

What doctors wish patients knew about sodium consumption

While sodium is an essential nutrient, most people consume too much and are not even aware they are doing so. The body needs a small amount of sodium to work properly, but in excess it can increase a person’s risk for developing high blood pressure, which can lead to heart disease and stroke. That is why it is important to understand where most salt intake comes from and how to lower it. More...

Looking for Upcoming Events & Webinars

Due to the number of upcoming events & webinars available, we send information for them in a separate email. See our last email:

Upcoming Events & Webinars