Government


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    CHS hit with Justice Department investigation

    Federal regulators are seeking information about the for-profit hospital operator's inpatient admissions and dialysis processes and procedures.

    By Updated 12 hours ago
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    Colin Campbell/Healthcare Dive
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    State attorneys general urge PBM reform

    The letter, sent on behalf of 39 state attorneys general to leaders in Congress, comes as lawmakers consider legislation to regulate the pharmacy middlemen.

    By Feb. 23, 2024
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    Trendline

    Surprise Billing

    Federal legislation banning surprise bills has hit a barrage of roadblocks, complicating efforts to protect consumers from unexpected out-of-network charges.

    By Healthcare Dive staff
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    HHS reaches second-ever ransomware settlement

    A mental healthcare provider didn’t have sufficient protections in place before a ransomware attack exposed the protected health information of more than 14,000 people, according to the HHS’ Office for Civil Rights.

    By Feb. 22, 2024
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    Steward Health Care gets ultimatum from Massachusetts governor

    Gov. Maura Healey sent a letter to Steward executives this week saying the operator must produce financial documents and consider a sale of its properties in the state.

    By Feb. 21, 2024
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    CMS finalizes rule to cut Medicaid DSH payments for some hospitals

    Under the new definition, hospitals can only receive disproportionate share hospital Medicaid reimbursements for beneficiaries who are primarily insured by the safety-net program.

    By Updated Feb. 22, 2024
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    Ukrainian national pleads guilty in Vermont hospital ransomware attack

    The attack against the University of Vermont Medical Center in 2020 cost the hospital millions of dollars and limited operations for weeks.

    By Feb. 20, 2024
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    No Surprises implementation created uptick in in-network claims: Fair Health

    From the fourth quarter of 2021 to the first quarter of 2022, in-network care as a percentage of all national claim lines increased 2.3%, the nonprofit found.

    By Feb. 20, 2024
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    Telehealth services during pandemic largely compliant with Medicare, OIG finds

    The latest audit from the HHS’ Office of Inspector General comes as some Medicare flexibilities for telehealth are set to expire at the end of this year.

    By Feb. 16, 2024
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    Disputes over surprise billing continue to soar, new CMS data shows

    Arbiters are mostly selecting the higher payment offer in billing dispute determinations. That suggests No Surprises could actually raise premiums for consumers, one health researcher said.

    By Feb. 16, 2024
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    House subcommittee grills VA, Oracle over pharmacy issues amid EHR rollout

    Implementation of the new electronic health record has been rocky, with system reliability and safety concerns plaguing the Department of Veterans Affairs.

    By Feb. 15, 2024
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    Data broker used phone location info to track Planned Parenthood visits, senator says

    Sen. Ron Wyden urged federal regulators to crack down on a data broker that allegedly used location data to track visits to clinics and target users with anti-abortion ads.

    By Feb. 14, 2024
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    Humana sued over alleged 340B underpayments in Medicare Advantage

    Alabama-based Baptist Health argued the insurer had received a “windfall” due to illegal payment cuts in the 340B drug discount program.

    By Feb. 13, 2024
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    Washington state bill seeks to regulate hospital mergers, care access

    The Washington state Senate advanced legislation Thursday that grants the state attorney authority to deny mergers that may limit healthcare access.

    By Feb. 13, 2024
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    FTC obtains $195M judgment against Simple Health for selling ‘sham’ insurance

    The Florida-based insurer deceived tens of thousands of consumers into purchasing what they believed was comprehensive coverage, but instead amounted to a medical discount membership.

    By Feb. 12, 2024
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    Lawsuit accuses Advocate Aurora of charging ‘eye-watering’ prices

    The lawsuit accuses the health system of using acquisitions, noncompetes and gag clauses to create a monopoly and increase prices.

    By Feb. 12, 2024
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    Pharma CEOs, pressed by Senate panel, refuse to commit to price cuts

    Forced into testifying by Senate HELP chair Bernie Sanders, the heads of Bristol Myers Squibb, J&J and Merck largely avoided major missteps.

    By Jonathan Gardner • Feb. 8, 2024
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    Senate finance committee weighs healthcare AI oversight

    Lawmakers considered how to prevent artificial intelligence from worsening bias or improperly denying coverage at a Feb. 8 hearing.

    By Feb. 8, 2024
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    Q&A

    HHS ambassador Ty Greenhalgh on what to expect from federal cybersecurity guidance in healthcare

    Ty Greenhalgh discusses what the Biden administration’s cybersecurity performance goals mean for the industry, and how they could lead to a tightening of the HIPAA Security Rule.

    By Feb. 8, 2024
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    AHA calls for more payer oversight in No Surprises dispute resolution

    In comments on a proposed rule, the American Hospital Association argued regulators haven’t fully addressed how they’ll handle oversight for some situations, like when an insurer fails to pay after a dispute determination.

    By Feb. 7, 2024
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    FDA panel recommends new standards for pulse oximeters amid bias concerns

    Studies have found that pulse oximeters overestimated oxygen saturation in people with dark skin pigmentation, resulting in delayed care.

    By Elise Reuter • Feb. 5, 2024
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    Humana flags potential MA funding dip if proposed rate notice finalized

    Despite the uncertainty, the insurer reaffirmed its earnings outlook for 2025.

    By Feb. 5, 2024
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    Providence erases or refunds $158M in medical bills

    The Renton, Washington-based nonprofit health system plans to spend millions to settle allegations it skirted charity care obligations between 2018 and 2023.

    By Feb. 2, 2024
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    HHS finalizes rule on telehealth at opioid treatment programs

    The rule marks the first substantial changes to treatment and delivery standards at opioid treatment programs in more than 20 years.

    By Feb. 2, 2024
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    Medicare Advantage plans could see rates dip slightly in 2025

    The CMS proposed a 0.2% dip in MA rates. However, analysts said regulators will likely improve the payment rate in the final notice.

    By Feb. 1, 2024
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    New CMS pilot to test payment scheme for pricey sickle cell gene therapies

    The CMS innovation center will coordinate insurance coverage across states to help patients access new treatments with multi-million-dollar price tags.

    By Ned Pagliarulo • Jan. 31, 2024