Health Law
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DOJ joins lawsuits alleging Kaiser Permanente committed Medicare fraud
Attempts to "defraud the program cannot continue and will be pursued," DOJ officials said in statement announcing the action against the California-based system.
By Samantha Liss • UPDATED: Aug. 2, 2021 at 12:36 p.m. -
Missouri Supreme Court backs Medicaid expansion in unanimous decision
Thursday's ruling is a decisive victory for Medicaid expansion proponents, the newly eligible and voters who ushered in enhanced coverage via a ballot initiative in 2020.
By Samantha Liss • July 23, 2021 -
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TrendlineLabor
While labor strife among healthcare workers is hardly new, the COVID-19 pandemic brought new issues to the table, including re-use of personal protective equipment and other safety measures.
By Healthcare Dive staff -
DaVita, former CEO charged for alleged noncompete conspiracies
The dialysis provider said the charges are unwarranted and rely on "alleged discussions involving former executives that occurred many years ago."
By Hailey Mensik • July 16, 2021 -
Mark Makela via Getty Images
Hospital mergers to get added scrutiny under Biden order
The hospital lobby is against the executive order, which calls on regulators to "enforce the antitrust laws vigorously" and reminds them to challenge prior bad mergers.
By Samantha Liss • UPDATED: July 12, 2021 at 11:09 a.m. -
Retrieved from American Association of Nurse Practitioners on July 06, 2021
Q&ANurse practitioners association past president reflects on pandemic, scope of practice rollbacks
The biggest challenge facing the profession is outdated regulatory barriers that don't allow nurse practitioners to practice at the top of their education and training, Sophia Thomas said.
By Hailey Mensik • July 06, 2021 -
SCOTUS will not hear hospitals' appeal against site-neutral payments
The rule barring hospitals from receiving higher reimbursements for outpatient services compared to other providers was widely challenged, but now stands with the high court's decision.
By Hailey Mensik • June 29, 2021 -
Biden administration aims to further rebuild ACA with proposed rule
The regulation would lengthen the annual open enrollment period, expand the role of navigators and nix Trump-era guidelines for waivers that were criticized for allowing states to skirt coverage requirements.
By Shannon Muchmore • June 29, 2021 -
Missouri judge blocks voter-approved Medicaid expansion
Despite of the win at the ballot box in 2020, the state legislature failed to make funds available to expand the program to about 230,000 low-income adults.
By Samantha Liss • June 24, 2021 -
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New York passes safe staffing law for hospitals, nursing homes
"This law doesn't state that ratios must be stipulated, but inevitably that's what it means," said Judy Sheridan-Gonzales, president of the New York State Nurses Association.
By Hailey Mensik • June 22, 2021 -
Supreme Court upholds ACA in 7-2 decision, leaving intact landmark US health law during pandemic
A wide swath of industry groups cheered the ruling, which held the plaintiffs lacked legal standing to bring the case.
By Samantha Liss • UPDATED: June 17, 2021 at 11:49 a.m. -
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The Supreme Court saved the ACA, again. It may not be the last word on challenges.
Will the 7-2 ruling put future efforts on ice? Even staunch backers of the law expect opponents to "come up with something."
By Samantha Liss • June 17, 2021 -
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MedPAC says lower clinical lab fees don't impact access, prompting industry ire
The clinical laboratory group, whose members include Quest and LabCorp, contends the report to Congress contains "biased" commentary that ignores the value of lab tests and importance of timely patient access.
By Nick Paul Taylor • June 17, 2021 -
Samantha Liss for Healthcare Dive
Centene shells out $143M to settle PBM disputes in Ohio, Mississippi
The settlement could be the first of many: The St. Louis-based payer is reserving a tranche of $1.1 billion to resolve similar claims in other states.
By Rebecca Pifer • June 15, 2021 -
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Industry awaits Supreme Court decision on ACA case
A ruling on the fate of the landmark law could come as early as Thursday morning.
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Courtesy of Exact Sciences
US panel trims colorectal cancer screening age, broadening payer mandate
The action means private insurers have to cover the screening of adults aged 45 to 49 years under the Affordable Care Act.
By Nick Paul Taylor • May 19, 2021 -
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HHS asks Supreme Court to keep site-neutral payments in place
Hospitals and HHS have been wrangling about the issue since the federal agency moved to cut payments to hospital-owned outpatient sites in 2019.
By Ron Shinkman • May 17, 2021 -
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Providers supportive of push to overhaul HIPAA, but air serious concerns about data privacy, timing
"We urge OCR to reconsider implementing a massive change to patient privacy laws in the midst of this transition," AMA commented on the Trump-era rule.
By Rebecca Pifer • May 10, 2021 -
C-suite execs want government action on rising healthcare costs, report finds
Business leaders overwhelmingly back policies to boost price transparency and antitrust enforcement to rein in the cost of coverage for employees, the Kaiser Family Foundation and Purchaser Business Group on Health poll found.
By Hailey Mensik • April 30, 2021 -
Drew Angerer via Getty Images
ACA navigator funds get massive boost to record level
The agency also said about 12 million people enrolled in an Affordable Care Act plan during the 2021 open enrollment period, a 5% increase from the year prior.
By Shannon Muchmore • April 22, 2021 -
Adeline Kon/Healthcare Dive
Lawmakers urge HHS to conduct 'vigorous oversight' of hospital price posts after reports of noncompliance
Hospitals are now required to publicly post the prices they negotiate with insurers online, but noncompliance is common. A bipartisan group from the House voiced their discontent in a letter to HHS Secretary Xavier Becerra.
By Samantha Liss • April 14, 2021 -
Payer lobbies cheer new bipartisan bill allowing audio-only telehealth in MA
"Lawmakers have recognized the importance of telehealth, and this important legislation recognizes that for many seniors, a phone call is their only option for health care at home," AHIP CEO Matt Eyles said Wednesday.
By Rebecca Pifer • March 25, 2021 -
UnitedHealth Group
AHA urges strict antitrust review of UnitedHealth's $13B Change buy
The diversified health giant declined to comment directly on anticompetitive concerns, though an Optum spokesperson argued the two companies have "distinct and complementary capabilities."
By Rebecca Pifer • March 19, 2021 -
Retrieved from C-SPAN on February 24, 2021
Becerra confirmed as HHS secretary
The 50-49 vote in the Senate was almost entirely along party lines. The only Republican to cross the aisle was Sen. Susan Collins of Maine.
By Shannon Muchmore • March 18, 2021 -
Permission granted by Health Affairs
Q&AHealth Affairs' Alan Weil reflects on 1 year of COVID-19
The editor in chief of the respected industry journal spoke with Healthcare Dive about the role of equity in health research, the staying power of telemedicine and how to effectively communicate important public health messages.
By Shannon Muchmore • March 18, 2021 -
Despite pandemic, MedPAC advises few changes to 2022 provider payments
To the extent that the effects of the crisis are temporary and vary significantly depending on provider, they're best addressed through targeted yet temporary funding policies, the congressional advisers said in an annual report.
By Rebecca Pifer • March 16, 2021
