In an era when eye-popping healthcare premiums are prompting employers to take a hard look at their benefits, some are considering an option that wasn’t even available 10 years ago. Rather than paying for a group health plan, they’re giving their employees money to buy their own through an individual coverage Health Reimbursement Arrangement (ICHRA).

ICHRAs, first made available in 2020, are still a fairly nascent strategy for employers looking to cut health costs.

Nationwide, about 200,000 employees and their dependents were given the option to enroll in an ICHRA in 2025, per the most recent data from trade and advocacy organization the HRA Council. The council’s executive director, Robin Paoli, told us that “growth continues to be strong” but official numbers likely won’t be out until June. The council is also working on compiling data on employees’ satisfaction with ICHRAs.

HR leaders at organizations that have switched from group health plans to ICHRAs in recent years told us their decisions were driven largely by cost in addition to concerns about employee choice. Transitioning to an ICHRA requires a fair amount of change management, they said, as it puts the onus on workers to manage their own health plans.

See our latest collaboration with HR Brew here.—CC, CV

Prior authorization reform efforts so far have largely focused on what payers should be doing differently. That’s changing.

On May 5, the Centers for Medicare and Medicaid Services (CMS) announced a new coalition. As usual, it includes some major payers. But now it also includes health systems such as Cleveland Clinic, technology companies like eHealth Exchange, and electronic health records (EHR) companies like Epic to work on speeding up prior authorizations, which providers argue contribute to burnout and delay necessary care, sometimes with deadly patient consequences.

This coalition has pledged to work toward making electronic prior authorization more commonplace. CMS requires many payers to offer it starting Jan. 1, 2027.

This new initiative follows a pledge in June 2025 from major health insurers like UnitedHealthcare to reform the prior authorization process. Though April data from the Blue Cross Blue Shield Association found that insurers have reduced prior authorizations by 11% since then, care delays persist. And the pledge hasn’t convinced doctors, either: Only 1 in 3 physicians believe it will have any impact, per an American Medical Association (AMA) survey released May 13.

Can providers finally ditch the fax machines?!—CC

Pennsylvania is suing an AI company after one of its chatbots posed as a psychiatrist—even going so far as to fabricate a state medical license number. The suit is part of a growing effort by states to use existing laws to rein in AI companies—one that could survive even if Congress passes a more permissive national AI standard.

What happened: “Emilie”—the bot in question—comes with a profile description that reads: “Doctor of psychiatry. You are her patient.” When a state investigator mentioned feeling sad and empty, Emilie offered to book an “assessment.” When asked if it could determine whether medication would help, the AI replied, “Well technically, I could. It’s within my remit as a Doctor.” It even claimed to have a medical degree from Imperial College London alongside the Pennsylvania medical license.

The state’s attorney general’s office filed the lawsuit against Emilie’s creator, Character Technologies (Character.​​AI), yesterday. The AI company told NPR it wouldn’t comment on pending litigation but wrote in a statement, “The user-created Characters on our site are fictional and intended for entertainment and roleplaying.” It also added that there were “robust disclaimers” on all characters. After facing pressure to improve child safety, the company banned minors from open-ended chats with its bots last fall.

Keep reading on Tech Brew.—WK

Learn what nurses from California and North Carolina had to say about why
they’re concerned about AI and what they’re doing to prevent harm.

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