Health Law
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PwC: 'New Health Economy' finding its feet, but challenges remain
Providers are embracing digital treatments, with 77% saying they have suggested an app or digital program to a patient, according to the industry trends report.
By Meg Bryant • Dec. 12, 2018
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Lawmakers impatient for ONC interoperability rule
"It is hard to explain to people that Congress provided the tools necessary for doctors and patients to better coordinate their care through the sharing of patient data, but nothing has changed," Rep. Michael Burgess, R-Texas, said at a House health subcommittee hearing.
By Rebecca Pifer • Dec. 11, 2018
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California imposes conditions on CHI-Dignity Health merger
The state approved the deal so long as the two health systems agree to certain measures meant to preserve access to care and financial aid. The two will operate 30 hospitals in California.
By Samantha Liss • Nov. 26, 2018
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Atrium Health agrees to stop anti-steering practices
The case involves a relatively new target for the Justice Department — restrictions imposed by providers to limit payers from moving patients to high-quality providers.
By Les Masterson • Nov. 16, 2018
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Deep DiveRed states say 'yes' to Medicaid
Three GOP-heavy states expanded Medicaid on Tuesday, and Democratic governor pickups could further the trend. Elsewhere on midterm ballots, nurse-to-patient staffing ratios lost and California hospitals scored a win.
By Rebecca Pifer • Nov. 07, 2018
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Judge shuts down Florida payer for selling plans FTC calls 'worthless'
Simple Health Plans misled people into thinking they were buying comprehensive health insurance, according to the Federal Trade Commission.
By Les Masterson • Nov. 05, 2018
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Land O'Lakes calls itself first to offer new association health plans
The Trump administration has encouraged AHPs to spur cheaper health insurance options, but critics call out flexibility for plans to offer skimpier protections.
By Les Masterson • Nov. 05, 2018
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MA plans could use more telehealth services under proposed rule
The proposal would also revise star ratings methodology and improve CMS efforts to recover improper payments.
By Les Masterson • Oct. 29, 2018
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ACA premiums would be lower if not for GOP efforts, report finds
Premiums in unsubsidized exchange plans will be 6% higher next year than if Congress and the White House didn't implement policy changes like zeroing out the individual mandate penalty, according the Kaiser Family Foundation.
By Les Masterson • Oct. 29, 2018
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Status quo or blue wave? How the midterms could hit healthcare companies
Election Day is here, and who voters send to Congress will have implications throughout the healthcare industry. Here's a reminder of the various scenarios.
By Samantha Liss • Oct. 25, 2018
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Trump signs opioids bill as GAO says government can do more
Also this week, CMS rolled out a payment model to improve care coordination for mothers with opioid use disorders.
By Meg Bryant • Oct. 25, 2018
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Loss of pre-existing condition protections would hit 100M, Avalere says
The analysis comes as the Trump administration props up skimpy health plan options and backs a Texas lawsuit seeking to repeal the ACA.
By Samantha Liss • Oct. 24, 2018
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Sutter requests competitor pricing data as part of antitrust lawsuit
Hospitals have balked at the request, saying the information is proprietary.
By Les Masterson • Oct. 17, 2018
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#AHIPMMD: Verma touts MA growth, blasts Medicare for all
So far, 270 Medicare Advantage plans will offer new benefits allowed for 2019 that include adult day care and meals, the CMS administrator said at the annual payer conference.
By Samantha Liss • Oct. 17, 2018
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Immigration rule change could force millions off Medicaid, report warns
The Trump administration is proposing a change to "public charge" policies that could also lead to higher costs for providers via uncompensated care and more ER visits, according to the Kaiser Family Foundation.
By Les Masterson • Oct. 15, 2018
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NLRB charges Detroit Medical Center with unfair labor practices
Nurses at Huron Valley-Sinai Hospital, who have been negotiating a union contract since 2016, have said the hospital is discriminating and not bargaining in good faith.
By Tony Abraham • Oct. 11, 2018
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Court awards $1.2M in missed CSR payments to Montana co-op
A judge last month ruled the government was statutorily obligated to make the payments and the obligation "was not vitiated by Congress's failure to appropriate funds for that purpose."
By Les Masterson • Oct. 09, 2018
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New plans in Iowa don't offer pre-existing condition protections
Meanwhile, a federal judge scheduled a hearing on short-term health plans for Oct. 26. The plaintiffs filed a motion in September arguing those plans will harm the health insurance industry.
By Les Masterson • Oct. 05, 2018
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CVS, Aetna defend merger potential to Connecticut regulators
The $69 billion deal is considered to have a good chance for approval. Aetna agreed last week to sell its standalone Medicare Part D business to help clear antitrust hurdles.
By Samantha Liss • Oct. 05, 2018
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Opioid interventions can curb overprescribing, boost MAT access, JAMA studies show
Though the root cause of the opioid crisis is still being debated, many attribute it to the rapid growth in prescribing starting in the 1990s and peaking in 2012 — a 300% expansion according to some metrics.
By Rebecca Pifer • Sept. 28, 2018
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Bipartisan opioid bill has IMD exclusion, expands MAT
The legislation, which also opens up non-addictive pain management alternatives and increases enforcement of illegal fentanyl, is expected to pass both houses as early as next month.
By Les Masterson • Sept. 27, 2018
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Safety-net hospitals get break on FY19 readmission penalties, analysis finds
Some penalties are being cut by half or more, and 65 safety-net facilities that were penalized last year will see no dock at all this year, according to a data review by Kaiser Health News.
By Les Masterson • Sept. 27, 2018
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Maryland reinsurance program credited for premium decreases
Before CMS approved the program, the state's four individual health plans requested an average increase of 30.2%, but they have now put forward rates with an average decrease of 13.2%.
By Les Masterson • Sept. 26, 2018
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New York regulator warns CVS-Aetna merger could raise prices, reduce consumer choice
The state's top financial watchdog said the pharmacy chain's PBM would have an incentive to give the largest drug discounts to Aetna members, causing "anti-competitive effects" in the rest of the market.
By Samantha Liss • Sept. 26, 2018
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CHS subsidiary coughs up $262M for fraud settlement
Health Management Associates incorrectly billed government payers in a physician kickback scheme between 2008 and 2012. With the settlement, the government agreed not to bring criminal charges against the hospital chain.
By Tony Abraham • Sept. 26, 2018