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    Supreme Court rules in favor of HHS in Medicare disproportionate share payments case

    The highest court upheld HHS' method of calculating Medicare payments to hospitals serving a high proportion of low-income patients, rebutting hospitals’ efforts to recoup potentially billions of dollars from the program.

    By June 27, 2022
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    'Chaos' from state abortion bans going into effect will have legal, criminal implications for providers

    The effect of Friday's opinion will be felt by providers, medical groups and hospitals across the country, including primary care doctors and emergency physicians, experts say.

    By June 24, 2022
  • Trendline

    Vertical integration and consolidation

    Healthcare companies merging with subsectors of the industry is a growing trend, although certainly not a new one.

    By Healthcare Dive staff
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    Megan Quinn/Healthcare Dive

    Firearm-safety law is move toward acknowledging gun violence as public health issue, physicians say

    Medical associations representing physicians voiced their support for the legislation and have recently strengthened their messaging on gun reform following mass shootings.

    By June 24, 2022
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    Supreme Court overturns Roe v. Wade, ending constitutional right to abortion

    As it currently stands, 26 states are deemed certain or likely to end abortion rights, making abortion effectively illegal in half of the country, according to the Guttmacher Institute.

    By June 24, 2022
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    Colorado first state to launch public option via federal waiver

    Through the waiver granted by the CMS on Thursday, Colorado can use federal funds to set up a government-run health plan, a long-held progressive healthcare goal.

    By June 24, 2022
  • SCOTUS rejects UnitedHealth appeal of Medicare Advantage overpayment rule

    The justices declined to take up the case, leaving intact a lower court ruling that backed the 2014 CMS regulation requiring swift return of overpayments.

    By Susan Kelly • June 22, 2022
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    Molina to pay $4.6M to settle False Claim Act allegations

    The settlement comes after whistleblowers brought a suit against Molina and a former subsidiary, alleging care at Massachusetts-based behavioral health clinics was given by inadequately trained and unsupervised clinicians.

    By June 22, 2022
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    Medicare data errors impede health equity efforts, OIG says

    The ability to assess health disparities and improve care delivery in communities of color hinges on the quality of race and ethnicity data that is currently falling short, the report said.

    By Susan Kelly • June 21, 2022
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    Washington ups pressure on PBMs with more aggressive FTC policy, congressional ask for GAO study

    The Federal Trade Commission has voted unanimously to adopt a policy statement to more closely examine fees and rebates paid to PBMs in exchange for preferred coverage of their drugs from payers.

    By June 21, 2022
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    Carol Highsmith. (2005). "The Apex Building" [Photo]. Retrieved from Wikimedia Commons.

    Pharma under the microscope as FTC considers new ways to review acquisitions

    At a two-day meeting, experts argued drug divestitures may not be enough to prevent market concentration. Economists and regulators also appeared worried by the effect of buyouts on innovation.

    By Jonathan Gardner • June 17, 2022
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    Expiration of healthcare subsidies will have domino effect, leading to higher prices and increased medical debt

    Millions of Americans will experience dramatic price increases, become uninsured and likely accrue medical debt, GetInsured’s Heather Korbulic argues.

    By Heather Korbulic • June 16, 2022
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    Apple Watch monitoring features for AFib, Parkinson's cleared by FDA

    With the new feature, atrial fibrillation patients may have an easier way to track the frequency of the condition over time and see whether lifestyle changes may have positive effects.

    By Nick Paul Taylor • June 16, 2022
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    FDA advisers recommend Pfizer, Moderna COVID-19 vaccines for youngest children

    Independent experts unanimously supported use of both shots in children aged 6 months to 5 years old, clearing the way for an FDA decision.

    By Ben Fidler • Updated June 15, 2022
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    Hospitals win SCOTUS case against 340B rate cuts

    The Justices were unanimous in their decision, with Justice Brett Kavanaugh writing it was “a straightforward case.”

    By June 15, 2022
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    Carol Highsmith. (2005). "The Apex Building" [Photo]. Retrieved from Wikimedia Commons.

    RWJBarnabas Health scraps hospital acquisition deal

    The nixed New Jersey deal marks another victory for the FTC, which stopped a separate hospital deal this year.

    By June 14, 2022
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    Most Medicare Advantage enrollees like their plans, survey finds

    As the program has soared in popularity, it has attracted the attention of federal investigators, including an HHS OIG report finding inappropriate prior authorization and claims denials.

    By Susan Kelly • June 14, 2022
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    Deep Dive

    Despite rosier trust fund outlook, time running out to stabilize Medicare funding, researchers warn

    Though it’s tempting to interpret the recent Medicare trustees report as good news, academics are arguing lawmakers can’t wait until hospital trust fund insolvency is imminent before taking action to bolster the program.

    By June 13, 2022
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    FDA staff supportive of Pfizer, Moderna COVID vaccines in young children

    Agency scientists found the shots to be similarly effective in kids as in older teenagers and raised no major safety red flags, documents published ahead of a meeting of agency advisers this week show.

    By Jonathan Gardner , Ned Pagliarulo • June 13, 2022
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    UnitedHealth Group

    FTC hits UnitedHealth, LHC with another request for information on $5.4B buy

    Marrying LHC, which manages a sizable share of the home health market, with Optum, one of the biggest physician groups in the country, has raised regulators’ eyebrows.

    By June 13, 2022
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    Hospital lobby urges CMS to delay enforcement of price estimate requirement

    The contested provision in the No Surprises Act requires certain providers to assemble a comprehensive cost estimate for patients, including costs from other providers that could step in to provide care.   

    By June 9, 2022
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    CMS issues first price transparency fines to 2 Georgia hospitals

    Regulators have been criticized for moving slowly to enforce the rules, which came into effect January last year amid fierce opposition from hospital groups.

    By June 9, 2022
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    HCA's purchase of 5 Utah hospitals from Steward on pause after judge's order

    The court will now weigh whether to issue a preliminary injunction and will hear from both parties before deciding whether to block the deal.

    By June 8, 2022
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    Carol Highsmith. (2005). "Apex Bldg." [Photo]. Retrieved from Wikimedia Commons.

    FTC launches investigation into PBMs; CVS, UnitedHealth, Cigna and more hit with requests for data

    Pharmacy groups cheered the news, which reversed a vote earlier this year by FTC commissioners not to investigate PBMs' pricing and contractual practices.

    By June 7, 2022
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    Leapfrog raises concerns about CMS proposal to suppress patient safety data

    The CMS is the only source for this data, and without it the public will not have information on preventable complications such as bed sores, inpatient falls that result in a broken hip, or sepsis, Leapfrog executives said.

    By June 6, 2022
  • Healthcare payrolls recovering, still lag pre-pandemic levels

    Hospitals led growth in healthcare jobs in May as the industry slowly rebuilds its pandemic-shaken workforce.

    By Susan Kelly • June 6, 2022