Government: Page 4
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Humana sued over alleged 340B underpayments in Medicare Advantage
Alabama-based Baptist Health argued the insurer had received a “windfall” due to illegal payment cuts in the 340B drug discount program.
By Emily Olsen • Feb. 13, 2024 -
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Washington state bill seeks to regulate hospital mergers, care access
The Washington state Senate advanced legislation Thursday that grants the state attorney authority to deny mergers that may limit healthcare access.
By Susanna Vogel • Feb. 13, 2024 -
Explore the Trendline➔
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TrendlineSocial determinants of health
The focus on social determinants of health has only increased because of the impacts of the pandemic, with payers and providers trying to new ways to address the issues.
By Healthcare Dive staff -
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FTC obtains $195M judgment against Simple Health for selling ‘sham’ insurance
The Florida-based insurer deceived tens of thousands of consumers into purchasing what they believed was comprehensive coverage, but instead amounted to a medical discount membership.
By Rebecca Pifer • Feb. 12, 2024 -
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Lawsuit accuses Advocate Aurora of charging ‘eye-watering’ prices
The lawsuit accuses the health system of using acquisitions, noncompetes and gag clauses to create a monopoly and increase prices.
By Susanna Vogel • Feb. 12, 2024 -
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Pharma CEOs, pressed by Senate panel, refuse to commit to price cuts
Forced into testifying by Senate HELP chair Bernie Sanders, the heads of Bristol Myers Squibb, J&J and Merck largely avoided major missteps.
By Jonathan Gardner • Feb. 8, 2024 -
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Senate finance committee weighs healthcare AI oversight
Lawmakers considered how to prevent artificial intelligence from worsening bias or improperly denying coverage at a Feb. 8 hearing.
By Emily Olsen • Feb. 8, 2024 -
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Q&AHHS ambassador Ty Greenhalgh on what to expect from federal cybersecurity guidance in healthcare
Ty Greenhalgh discusses what the Biden administration’s cybersecurity performance goals mean for the industry, and how they could lead to a tightening of the HIPAA Security Rule.
By Brian T. Horowitz • Feb. 8, 2024 -
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AHA calls for more payer oversight in No Surprises dispute resolution
In comments on a proposed rule, the American Hospital Association argued regulators haven’t fully addressed how they’ll handle oversight for some situations, like when an insurer fails to pay after a dispute determination.
By Emily Olsen • Feb. 7, 2024 -
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FDA panel recommends new standards for pulse oximeters amid bias concerns
Studies have found that pulse oximeters overestimated oxygen saturation in people with dark skin pigmentation, resulting in delayed care.
By Elise Reuter • Feb. 5, 2024 -
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Humana flags potential MA funding dip if proposed rate notice finalized
Despite the uncertainty, the insurer reaffirmed its earnings outlook for 2025.
By Rebecca Pifer • Feb. 5, 2024 -
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Providence erases or refunds $158M in medical bills
The Renton, Washington-based nonprofit health system plans to spend millions to settle allegations it skirted charity care obligations between 2018 and 2023.
By Susanna Vogel • Feb. 2, 2024 -
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HHS finalizes rule on telehealth at opioid treatment programs
The rule marks the first substantial changes to treatment and delivery standards at opioid treatment programs in more than 20 years.
By Emily Olsen • Feb. 2, 2024 -
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Medicare Advantage plans could see rates dip slightly in 2025
The CMS proposed a 0.2% dip in MA rates. However, analysts said regulators will likely improve the payment rate in the final notice.
By Rebecca Pifer • Feb. 1, 2024 -
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New CMS pilot to test payment scheme for pricey sickle cell gene therapies
The CMS innovation center will coordinate insurance coverage across states to help patients access new treatments with multi-million-dollar price tags.
By Ned Pagliarulo • Jan. 31, 2024 -
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FDA extends deadline for comments on role of digital health in diabetes detection
The agency is seeking answers on how digital health technologies could be used in the detection of prediabetes and Type 2 diabetes.
By Nick Paul Taylor • Jan. 31, 2024 -
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Medicare ACO participation grows in 2024: CMS
However, growth in Medicare's flagship shared savings model has plateaued over the past five years, according to government data.
By Rebecca Pifer • Jan. 30, 2024 -
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FTC sues to block Novant purchase of two CHS hospitals
Regulators filed a lawsuit on Thursday to block North Carolina-based Novant Health from expanding its grip on healthcare in the state, warning a buy would increase costs.
By Susanna Vogel • Jan. 25, 2024 -
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HHS releases voluntary cybersecurity goals for the healthcare sector
The resources serve as a “step forward” as the agency looks to propose enforceable standards, HHS Deputy Secretary Andrea Palm said.
By Emily Olsen • Jan. 25, 2024 -
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Senator probes MA exchanges’ marketing tactics
The head of the Senate Finance Committee sent letters to several health insurance exchanges on Tuesday, as part of an inquiry into allegedly predatory Medicare Advantage marketing to seniors.
By Sydney Halleman • Jan. 24, 2024 -
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Tracking Steward's declineLawmakers press Steward Health Care over reports of ‘grave financial distress’
Lawmakers demanded the operator detail how it will "ensure the communities Steward’s hospitals serve are not abandoned" amid financial troubles.
By Susanna Vogel • Jan. 24, 2024 -
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Sponsored by TeleperformanceImplementing high-tech, high-touch digital services to create more personalized, patient-centric care
Improve the patient experience by addressing high interaction volume and channel complexity.
By Jeff Hechemy, Executive Vice President – Healthcare at Teleperformance • Jan. 22, 2024 -
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CMS finalizes rule tightening prior authorization turnaround for insurers
Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones — that should cut back coverage determination limbo for patients.
By Rebecca Pifer • Jan. 17, 2024 -
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MA spending to outstrip traditional Medicare by $88B this year: MedPAC
MedPAC released the data Friday during a contentious meeting where members argued over the efficacy of Medicare Advantage.
By Rebecca Pifer • Jan. 16, 2024 -
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HCA granted extension to respond to Mission lawsuit
The for-profit is being sued for allegedly cutting back medical care at Mission Hospital since purchasing the North Carolina facility in 2019.
By Susanna Vogel • Jan. 12, 2024 -
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ACA enrollment for 2024 reaches record high
More than 20 million Americans have signed up for Affordable Care Act plans since open enrollment began in November. Sign-ups are expected to continue to grow.
By Rebecca Pifer • Jan. 11, 2024
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