Health Law
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Trump admin pitches sweeping plan to reorganize HHS, government
Among the proposals is creation of a permanent “Council on Public Assistance" with authority to set uniform work requirements across Medicaid and other programs. Congress must sign off on most of the ideas.
By David Lim , Tony Abraham • June 22, 2018
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CMS seeks input on Stark Law changes amid value-based care shift
The American Hospital Association has been vocal in pushing for changes to the physician self-referral law, calling it outdated.
By David Lim • June 21, 2018
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MD Anderson slapped with $4.3M HIPAA fine
An HHS investigation into three data breaches found the health information of more than 33,500 people was compromised. The hospital contends no patient information was in jeopardy and said it will appeal.
By Tony Abraham • June 20, 2018
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AMA opposes CVS-Aetna deal
Company officials argued the deal could reduce healthcare spending, improve efficiencies and help patients with chronic illnesses, but the AMA said less healthcare competition would be bad for consumers.
By Les Masterson • June 20, 2018
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Trump admin finalizes Association Health Plans expansion
The final rule appears to contain protections for pre-existing conditions, age and gender, but allows AHPs to skirt the ACA's 10 essential health benefits.
By David Lim • UPDATED: June 20, 2018 at 10:05 a.m.
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Hospitals to lose $218B in federal payments by 2028, study predicts
The Federation of American Hospitals and the American Hospital Association commissioned a report to look at how 11 pieces of legislation, combined with regulatory changes, are affecting hospital reimbursement.
By Les Masterson • June 18, 2018
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Leapfrog pans CMS rule rolling back some quality reporting measures
The group that advocates for hospital quality said the change to the Inpatient Quality Reporting Program would be a blow to transparency and would reduce penalties for errors and infections.
By Les Masterson • June 15, 2018
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Loosening scope of practice rules could improve care and costs, report argues
Two healthcare economists suggested cutting policies that mandate supervisory and formal collaborative practice agreements.
By Les Masterson • June 14, 2018
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ED visits increased nearly 10% in California after ACA
A Health Affairs study also found the chance of a Medicaid enrollee being a frequent ED user was "significantly lower" after the Affordable Care Act was signed into law.
By Les Masterson • June 08, 2018
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DOJ argues ACA pre-existing condition, individual mandates unconstitutional
The Trump administration said that with Congress zeroing out the penalty starting in 2019, the health law's individual mandate, community rating and guaranteed issue provisions cannot stand.
By David Lim • UPDATED: June 8, 2018 at 1:10 p.m.
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Study raises concerns about Medicaid managed care's narrow networks
A Health Affairs report said states need to make sure that physician turnover in narrow network plans doesn't create issues with doctor continuity for vulnerable populations.
By Les Masterson • June 07, 2018
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Bucking national trend, Pennsylvania payers seek modest exchange premium hikes
While many states worry there will be less competition in the individual market next year, Pennsylvania is seeing an uptick of participation in the exchange.
By Les Masterson • June 06, 2018
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Medicaid expansion improved care access and coverage, analysis finds
More than 30 states have expanded Medicaid under the ACA, and a few more will have the issue up for a vote this fall.
By Les Masterson • June 06, 2018
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Losing ACA mandate penalty will reverse coverage gains, report finds
A Brookings analysis that focused on those not eligible for ACA subsidies found the individual mandate was the major reason the group got insured.
By Les Masterson • June 04, 2018
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AMA trumpets physician efforts in opioid epidemic fight
The doctors' group said opioid prescriptions are down while prescription drug monitoring program queries are up.
By Les Masterson • June 01, 2018
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Healthcare groups mixed on proposed direct provider contracting model
Some groups support DPC as a way to increase access to alternative payment models, but others fear it is too redundant and encouraged CMS to fix other programs instead.
By Les Masterson • May 30, 2018
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ACA health insurance tax would be delayed 2 years under bipartisan bill
Insurance companies say ending the tax would let them reduce premiums by 3%.
By Les Masterson • May 29, 2018
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Medicaid expansion sees movement in Virginia, may get vote in Idaho
Virginia could become the next state to expand Medicaid, with the state legislature expected to vote in the coming days on a plan that would tax hospitals to fund the added coverage.
By Les Masterson • May 29, 2018
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Comments criticize CMS plan to cut Medicaid care access monitoring
Healthcare officials said the change could especially hurt rural hospitals and force facilities to take lower rates without any recourse.
By Les Masterson • May 24, 2018
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NYC Health + Hospitals seeks $11M from UnitedHealthcare over denied claims
The health system said it is also reviewing its managed care contracts and may seek arbitration with other insurers down the road.
By Tony Abraham • May 23, 2018
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Sutter files to dismiss California AG's antitrust suit
The health system is accusing California Attorney General Xavier Becerra of a "sweeping and unprecedented effort to intrude into private contracting."
By Tony Abraham • May 17, 2018
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Cook County Health lost $165M from errors, lax policies, IG says
Officials blamed the system’s bureaucracy, employee mistakes and changes to health insurance.
By Les Masterson • May 17, 2018
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CMS' Verma says no to Medicaid lifetime limits
The administrator said the agency is still closely working with states on other types of waivers.
By David Lim • May 16, 2018
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Urban Institute pitches moderate plan to achieve comprehensive coverage
The proposal would keep most of the current healthcare structure in place, including employer-sponsored insurance, and could result in 16 million fewer people without insurance.
By Les Masterson • May 15, 2018
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Vermont all-payer ACO shows early success
Meanwhile, the federal government approved Maryland's request to expand its all-payer model. Beginning in January, across-the-board rates in the state will include hospital and non-hospital settings.
By Les Masterson • May 15, 2018