Health Law
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As Medicaid work requirements cost taxpayers $408M, government watchdog calls for more oversight
"More money, fewer people with care. And you paid for 87% of it!," Andy Slavitt, who headed up CMS under former President Barack Obama, tweeted of the administrative costs associated with Medicaid work requirements.
By Samantha Liss • Oct. 11, 2019 -
Idaho latest to attempt work requirement for Medicaid expansion
More than a dozen states across the country have sought approval to impose work requirements on Medicaid enrollees, but judges have blocked previous proposals.
By Samantha Liss • Sept. 30, 2019 -
Sutter antitrust trial opens, with implications for M&A across US
A ruling against the hospital system would send waves through the hundreds of providers that have been steadily consolidating in the past 25 years. A win could send prices both in California and the rest of the nation even higher.
By Ron Shinkman • Sept. 23, 2019 -
Judge dismisses Oscar antitrust lawsuit against Florida BCBS
Florida Blue's contract requiring brokers to sell insurance only for Florida Blue or risk losing access to all of its product lines is lawful, the federal judge wrote in his opinion.
By Rebecca Pifer • Sept. 23, 2019 -
Texas docs, pharmacists charged in alleged opioid pill mill scheme
The Justice Department charged 58 people, including 16 doctors or medical professionals, claiming they participated in schemes to defraud Medicare, Medicaid and other government programs.
By Dana Elfin • Sept. 19, 2019 -
Hospitals score victory as judge tosses CMS site neutral rule
The court kicked the matter back to HHS, ordering it determine how to work out remedies for payments withheld due to the final rule.
By Dana Elfin • Sept. 18, 2019 -
Nursing home operator gets 20-year sentence in $1B healthcare fraud case
The government used advanced data analysis and forensic accounting to uncover the full scope of the Miami-area scheme that bilked Medicare and Medicaid.
By Dana Elfin • Sept. 13, 2019 -
Employers urged to get off sidelines to trim healthcare costs
"Healthcare is not their day job. They build ships. They stock groceries," the CEO of the Pacific Business Group on Health said. "But as costs go up, they're the ones paying it."
By Rebecca Pifer • Sept. 11, 2019 -
CHS hospital fined $85K in first HIPAA right of access case
The Office of Civil Rights began looking into the Florida hospital following a complaint from a woman seeking prenatal health records for her child.
By Rebecca Pifer • Sept. 09, 2019 -
Kaiser to reveal detailed financials under newly signed California bill
As a not-for-profit operator, the giant health system previously was exempt from many of the state's reporting requirements.
By Rebecca Pifer • Sept. 06, 2019 -
Judge finally blesses CVS-Aetna merger settlement
The review was unprecedented, spanning nearly a year as District Court Judge Richard Leon decided whether the agreement was in the public interest.
By Samantha Liss • Sept. 04, 2019 -
DOJ investigating Providence St. Joseph's Swedish Health Services
The civil probe is seeking documents related to joint ventures and physician organizations.
By Samantha Liss • Aug. 30, 2019 -
Oklahoma judge orders J&J pay $572M in landmark opioid case
"We ask the judge to ensure that needed funds are directed to the hospitals and health systems that are on the forefront of caring for the victims of this epidemic," AHA said in a joint statement with the Oklahoma Hospital Association.
By Ned Pagliarulo • Aug. 26, 2019 -
ACA enrollment could stabilize if premiums stay flat
Critics had feared that Republican efforts to undermine the ACA would lead to large decreases in the number of people enrolled in plans sold in the individual insurance market, though a report shows a small decrease in 2019's Q1.
By Linda Wilson • Aug. 22, 2019 -
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
