Health Law
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Obamacare exchange consumers stick around longer. Does that mean they're sicker?
The churn expected within the ACA exchanges did occur, though not as fiercely as expected. Now the tide is shifting.
By Samantha Liss • Aug. 20, 2019 -
CMS chief unable to provide details on Trump healthcare plan
But Seema Verma did confirm the healthcare agency is "actively engaged in conversations" around the long-awaited plan.
By Rebecca Pifer • Aug. 16, 2019 -
Most providers not fully compliant with HIPAA access requirements, research shows
The most common problem was providers not sending health records via email when patients requested them. About a quarter of providers were also potentially noncompliant with the health privacy law's fee limitations.
By Shannon Muchmore • Aug. 15, 2019 -
Hospitals facing likely DSH payment cuts after appeals court ruling
A federal appeals court reinstated a 2017 rule allowing Medicare and private insurance payments to be included in how Disproportionate Share Hospital reimbursements are calculated.
By Dana Elfin • Aug. 15, 2019 -
Q&ACalifornia's AG on future of ACA suit, CVS-Aetna union
Xavier Becerra talked to Healthcare Dive about suing Sutter, J&J and what could be his most influential case yet: defending the Affordable Care Act.
By Dana Elfin • Aug. 08, 2019 -
CMS wants to force hospitals to reveal negotiated rates. Can it do that?
The Trump administration believes language in the Affordable Care Act gives it the authority to demand details on secret pricing contracts, but legal experts are divided.
By Samantha Liss • Aug. 05, 2019 -
HCA off the hook for claims it gave sweetheart deals to docs
A whistleblower didn't provide sufficient details to link the hospital giant to improper Medicare payments, an appeals court said, tossing a False Claims Act suit.
By Dana Elfin • Aug. 02, 2019 -
Judge nixes New Hampshire's Medicaid work requirement
The ruling is the third time the judge has shot down such demonstration projects, having vacated similar plans in Arkansas and Kentucky on identical grounds.
By Dana Elfin • July 30, 2019 -
CMS proposes forcing hospitals to reveal negotiated rates
Insurer and hospital groups swiftly pushed back against a mandate to publish payer-specific rates for at least 300 services that patients can plan in advance. A legal challenge is likely.
By Samantha Liss • July 30, 2019 -
Senate advances drug pricing bill, setting up September vote
PhRMA's CEO, along with a number of drugmaker executives, met with President Trump this week to lay out their opposition to the bill.
By Jonathan Gardner • July 26, 2019 -
Senate committee targets Medicare drug price increases with bipartisan bill
Legislation proposed Tuesday would also reimburse physicians less for administering expensive intravenous drugs to beneficiaries.
By Jonathan Gardner • July 23, 2019 -
CMS' Verma blasts 'Medicare for All,' public option in rhetoric ramp up
The remarks were unusually strong for the CMS leader. Though she has often beat the party drum on plans conservatives call a dangerous step toward socialism, the breadth and specifics of her critique expanded.
By Rebecca Pifer • July 23, 2019 -
Judge upholds short-term plan expansion in Trump win against ACA
The plaintiffs, including the Association for Community Affiliated Plans, the National Alliance on Mental Illness and AIDS United, appealed the decision upholding the controversial policy Monday.
By Rebecca Pifer • UPDATED: July 29, 2019 at 2:22 p.m. -
Surprise billing legislation saves $7.6B, trims premiums, budget watchdog says
The sweeping Senate bill, which also tackles drug costs and bars certain contracts between payers and providers, was passed out of committee with bipartisan support last week.
By Samantha Liss • July 17, 2019 -
Surprise billing fight escalates as providers win arbitration add to House bill
Insurers and health policy experts are pushing back against the controversial change to the bill, which will let providers or payers appeal to an independent arbiter in cases where the median in-network rate tops $1,250.
By Rebecca Pifer • UPDATED: July 17, 2019 at 4:11 p.m. -
Plaintiffs in ACA lawsuit may not have exchange plans. Could that derail the entire challenge?
The two men claim the individual mandate forces them to buy expensive insurance. But they may no longer have minimum essential coverage, raising questions about whether they have standing in the high-profile case.
By Samantha Liss • July 12, 2019 -
Appeals court judge on ACA: 'Congress can fix this'
Two Republican-appointed judges hammered Democrats on whether the ACA's individual mandate was severable from the rest of the law and asked why Congress expected them to find a solution.
By Samantha Liss , Dana Elfin • July 10, 2019 -
Republican bid to dismantle ACA takes center stage
A federal appeals court in New Orleans heard oral arguments Tuesday in a ruling that could send ripples across the industry.
By Dana Elfin • July 08, 2019 -
DOJ, House, states tell appeals court it has authority to hear ACA case
Ahead of Tuesday's oral argument, parties in the appeal over the constitutionality of the Affordable Care Act filed briefs telling the court it has jurisdiction because a live controversy exists.
By Dana Elfin • July 08, 2019 -
Healthcare Dive's 10 biggest stories of the spring
From Amazon pushing into the prescription delivery sector to CVS-Aetna struggling to finalize their merger settlement agreement, read the top stories from the first half of the year.
By Rebecca Pifer • July 08, 2019 -
Air Methods, Global Medical Response most at risk with surprise billing ban
Large air ambulance companies have the most to lose should a ban on balance billing become law, a new report says.
By Ron Shinkman • July 08, 2019 -
Court rejects GOP bid for oral argument delay in ACA appeal
The coalition of Democratic attorneys general defending the law's constitutionality wants the court to rule on the appeal by the end of the year. The fight is expected to make its way up to the Supreme Court.
By Dana Elfin • July 02, 2019 -
Appeals court request throws wild card into ACA case
If the Democratic AGs and the House of Representatives don't have standing, "there's nothing to fight about and no disagreement," Georgetown health policy expert Katie Keith said. "The case is moot."
By Dana Elfin • UPDATED: July 2, 2019 at 10 a.m. -
Supreme Court to hear $12B risk corridor case next term
The Chamber of Commerce urged the court to take the case, warning that if the government is allowed to renege on its promised payments it could scare off the business community from working with the government.
By Dana Elfin • June 25, 2019 -
Court says CVS exec's move to PillPack violated noncompete
Jefferies analysts said the case documents show Amazon is seeking to bypass pharmacy benefit managers and contract directly with payers for its services, a negative signal for the PBM industry.
By Dana Elfin • June 20, 2019
