Health Law

Choice grows in ACA exchanges, report finds, as Supreme Court mulls effort to kill law

A new McKinsey & Company analysis comes as the high court convenes Friday to decide whether to review the Republican lawsuit seeking to overturn the landmark law.
By Rebecca Pifer • Feb. 21, 2020
Trump admin's Medicaid work requirements struck down by appeals court

The unanimous opinion from the D.C. federal appeals court is a blow to the administration's push to tie Medicaid coverage to employment. Legal experts say the ruling will stall the policy in other states like Indiana and Michigan.
By Samantha Liss • Feb. 14, 2020
Tenet to pay $1.4M to settle claims it implanted cardiac monitors unnecessarily

The allegations stemmed from a lawsuit filed by a medical center employee who will share in the settlement and is set to receive nearly $241,000.
By Samantha Liss • Feb. 12, 2020
Rival surprise billing efforts jockey for attention in election year

Two new pieces of draft legislation, one from the House Ways and Means committee and another from the Education and Labor panel, were introduced Friday as Congress struggles to make headway on the issue.
By Rebecca Pifer • UPDATED: Feb. 10, 2020 at 9:55 a.m.
Lawmakers push for more oversight at CMS innovation center

A bipartisan group in the House introduced a bill that would require HHS to track how demonstration models impact patient access to care and potentially overhaul or eliminate those found to have adverse effects.
By Hailey Mensik • Feb. 05, 2020
Private payers unlikely to take major hit from Medicaid block grant plan

Managed care covers a large swath of the nation's Medicaid beneficiaries, but analysts maintained a positive view on the sector after details emerged of the CMS policy.
By Samantha Liss • Feb. 03, 2020
Backing for unique patient identifier picks up steam at ONC conference

The current ban on funding UPIs is "misguided policy," Rep. Bill Foster, D-Ill., said Monday at the gathering of IT and industry officials. But other experts warned it's "not a panacea."
By Rebecca Pifer • Jan. 28, 2020
Impeachment trial, election won't dampen health investment, Fitch says

Despite the potential for regulatory changes late in the year, the outlook for healthcare products and services remains strong and the frenetic pace of M&A is unlikely to slow much, according to the ratings agency.
By Rebecca Pifer • Jan. 24, 2020
The Supreme Court isn't done with the ACA case yet. Here are the next steps.

The court is scheduled to review the challenge to the ACA on Feb. 21 to potentially weigh taking the case. However, legal experts cautioned it's common for the court to reschedule or relist cases for a later conference date.
By Samantha Liss • UPDATED: Feb. 6, 2020 at 8:26 a.m.
Supreme Court declines to quickly hear ACA case

It's now unlikely that the case will be decided before the election, which will thrust the debate over the fate of the landmark law into the spotlight during another presidential campaign.
By Samantha Liss • Jan. 21, 2020
After 2 years of turmoil, state exchange premiums stable for now, report finds

More robust reinsurance programs and commercial offerings from insurers such as Bright Health and upstart Oscar are playing a role, according to the Robert Wood Johnson Foundation and Urban Institute.
By Ron Shinkman • Jan. 17, 2020
CMS rejects Wyoming's bid to expand Medicaid to regulate air ambulances

The agency said the proposal was in conflict with existing federal law and failed to advance the core objective for the program.
By Samantha Liss • Jan. 16, 2020
Racial and ethnic disparities in care narrowed under ACA, Commonwealth Fund says

Previous progress in lowering the uninsured rate stalled after 2016.
By Linda Wilson • Jan. 16, 2020
Hospitals, insurers urge Supreme Court to hear ACA case to avert havoc

Lobbying groups said the case could take years to play out without the high court stepping in to hear arguments now.
By Samantha Liss • Jan. 15, 2020
AHA files another challenge to CMS site neutral payment policy

The same court ruled in favor of hospitals in September, but later determined it could not keep CMS from attempting the policy again for 2020.
By Shannon Muchmore • Jan. 14, 2020
Dignity Health loses appeal of Medicaid out-of-network billing case

The hospital operator said it may try to take the case against L.A. Care, the largest public Medicaid managed care plan in the country, to the California Supreme Court.
By Ron Shinkman • Jan. 13, 2020
Supreme Court to take on PBM rate regulation

A federal appeals court previously ruled in favor of pharmacy benefit managers, finding federal law preempts states from regulating their rates.
By Samantha Liss • Jan. 13, 2020
Opponents to Supreme Court: No rush to take pivotal ACA case

The Trump administration argues recent decisions removed "any exigency" for the high court to immediately take the case that could upend the landmark law.
By Samantha Liss • UPDATED: Jan. 14, 2020 at 10:06 a.m.
Kansas to become 37th state to expand Medicaid under ACA

Kansas joins a flurry of Republican-leaning states that have either expanded the program through their legislatures or via voter initiative, including Utah, Idaho and Nebraska.
By Ron Shinkman • Jan. 10, 2020
Insurance startup Bright Health eyes California with 1st payer acquisition

The deal is the company's first buy of another health insurer and a pivot to M&A as it pursues an aggressive growth strategy.
By Rebecca Pifer • Jan. 09, 2020
DOJ joins whistleblower suit against Indiana system for alleged Stark violation

Community Health Network is accused of submitting as many as hundreds of thousands of fraudulent claims to Medicare and other federal programs from at least 2008 to 2017.
By Rebecca Pifer • Jan. 08, 2020
Beyond the ACA: Healthcare legal fights to watch in 2020

Payers and providers are contesting a price transparency push. The Trump administration is also being challenged over risk corridor payments and the expansion of association health plans.
By Shannon Muchmore , Samantha Liss • Jan. 06, 2020
Providers embrace loosening Stark Law regulations, suggest feds could go further

The Trump administration's proposed relaxation of regulations around the law has nearly unanimous support in both the hospital and physician community, most of whom say they are chafing against the requirements.
By Ron Shinkman • Jan. 06, 2020
Supreme Court says ACA opponents have until Friday to respond to motion to expedite

The court set the deadline Monday after a push by the law's supporters to have the case heard before this year's presidential election.
By Samantha Liss • UPDATED: Jan. 7, 2020 at 10:35 a.m.
In win for big payers, appeals court sides with HHS in risk adjustment case

AHIP and the Blues argued it would be inconceivable to come up with an entirely new formula for the payments created under the Affordable Care Act.
By Samantha Liss • Jan. 03, 2020