Government


  • The Merck & Co. sign at the company's building in Summit, New Jersey.
    Image attribution tooltip
    Kena Betancur via Getty Images
    Image attribution tooltip

    Merck sues to stop Medicare negotiation of drug prices

    The drugmaker’s lawsuit claims the new pricing powers granted by the Inflation Reduction Act are unconstitutional and “tantamount to extortion.”

    By Christopher Newman • June 6, 2023
  • money
    Image attribution tooltip
    Stock via Getty Images
    Image attribution tooltip

    Friday Health Plans to shut down as state regulators step in

    In a statement, the insurer said it was “unable to scale our financial infrastructure to match the pace of our growth and secure the additional capital required to run our business.”

    By Emily Olsen • June 5, 2023
  • Trendline

    Labor

    Amid a surge in COVID-19 cases, hospitals need nurses so desparetly they're offering massive sign-on bonuses and staffing firms say open positions for both temporary and permanent nursing roles are at all-time highs

    By Healthcare Dive staff
  • Detail view of the US Capitol east facade in the early morning sun.
    Image attribution tooltip
    drnadig via Getty Images
    Image attribution tooltip

    Biden signs debt deal, clearing path for $27B in COVID-19 clawbacks

    Some of the funding is healthcare-related, and major programs like Medicaid and Medicare emerged unscathed after weeks of negotiations between Republicans and Democrats.

    By June 5, 2023
  • An image of a gavel and stethoscope.
    Image attribution tooltip
    Moussa81 via Getty Images
    Image attribution tooltip

    Tenet to pay over $29M to settle kickback allegations at Detroit Medical Center

    The Department of Justice alleged two DMC hospitals offered the services of mid-level practitioners to physicians in exchange for Medicare patient referrals.

    By Emily Olsen • June 2, 2023
  • Text of the word 'Medicaid' in the middle of a U.S. dollar bill
    Image attribution tooltip
    zimmytws via Getty Images
    Image attribution tooltip
    Medicaid redeterminations

    Over half a million disenrolled amid Medicaid redeterminations so far

    A KFF analysis of 11 states found many of the people who have already been removed from the Medicaid program were disenrolled for procedural reasons.

    By Emily Olsen • June 1, 2023
  • Vials of Eisai and Biogen's new Alzheimer's drug Leqembi
    Image attribution tooltip
    Courtesy of Leqembi
    Image attribution tooltip

    Medicare keeps limits on Alzheimer’s drug coverage, but loosens policy

    The agency will reimburse Alzheimer’s treatments if they receive full FDA approval, but plans to still require data collection via a patient registry.

    By Christopher Newman • June 1, 2023
  • A parent types at a laptop, holding a baby
    Image attribution tooltip

    Photo by Sarah Chai from Pexels

    Image attribution tooltip

    Postpartum people could lose coverage amid Medicaid redeterminations

    People in some states could lose postpartum coverage 60 days after giving birth, even though health risks from pregnancy can continue for months, according to a new report from KFF.

    By Emily Olsen • May 30, 2023
  • The White House in Washington DC at summer day.
    Image attribution tooltip
    lucky-photographer via Getty Images
    Image attribution tooltip

    Healthcare provisions of the debt limit deal: COVID-19 funding clawbacks, no Medicaid work requirements

    Congressional Republicans and the White House reached a deal over the weekend to raise the debt ceiling that includes healthcare policy wins for both sides of the aisle.

    By May 30, 2023
  • A picture of the exterior of a CVS Pharmacy with the logo and name in view.
    Image attribution tooltip
    Bruce Bennett via Getty Images
    Image attribution tooltip

    CVS could lose up to $1B next year from MA star ratings drop

    Just 21% of CVS’ MA members are currently in plans with a star rating of at least four, down from 87% at the end of 2021, the payer disclosed.

    By May 26, 2023
  • a medicaid insurance card on top of a small American flag
    Image attribution tooltip
    Kameleon007 via Getty Images
    Image attribution tooltip
    Medicaid redeterminations

    Two-thirds of Medicaid enrollees unaware of redeterminations, survey finds

    The KFF survey found many enrollees weren’t sure whether states are now allowed to remove people from the program, and 27% wouldn’t know where to look for coverage if they were ineligible for Medicaid.

    By Emily Olsen • May 25, 2023
  • a picture of matt eyles at a desk
    Image attribution tooltip

    Bill Clark/CQ Roll Call/Newscom

    Image attribution tooltip

    AHIP chief executive to step down in October

    Matt Eyles will depart after serving nearly five years as CEO of AHIP. The organization is launching a nationwide search for his replacement.

    By May 25, 2023
  • A stethoscope rests on a medical insurance claim form.
    Image attribution tooltip
    iStock / Getty Images Plus via Getty Images
    Image attribution tooltip

    US projected to hit record-low uninsurance rate this year

    But as federal aid expires, lower-income Americans — who saw the largest insurance gains during the pandemic — will likely be affected the most, according to experts.

    By May 24, 2023
  • Image attribution tooltip
    Getty Images
    Image attribution tooltip

    Biden administration aims to increase Medicaid drug transparency

    The notice of proposed rulemaking recommends that the CMS and states get a drug price verification survey tool and negotiate for expensive drugs under Medicaid.

    By Brian T. Horowitz • May 24, 2023
  • Rep. Comer sits in front of a poster outlining the cost differences between a drug dispensed at Cost Plus Drugs versus CVS.
    Image attribution tooltip
    Rebecca Pifer/Healthcare Dive
    Image attribution tooltip

    House lawmakers, PBM lobby spar over committee hearing

    At the latest congressional inquiry into pharmacy benefit managers, lawmakers argued the middlemen profit at the expense of patients and taxpayers.

    By May 24, 2023
  • a picture of a red stethoscope on top of a US billed money.
    Image attribution tooltip
    Adeline Kon/Healthcare Dive/Healthcare Dive
    Image attribution tooltip

    Pharma-backed report targets federal clinics for benefiting financially from 340B drug discounts

    Those grantees on average are reimbursed almost four times more for 340B prescription drugs than what they pay, and make billions in 340B drug margin, according to the report, which was funded by Gilead Sciences.

    By May 23, 2023
  • House of Representatives
    Image attribution tooltip
    Brendan Hoffman via Getty Images
    Image attribution tooltip

    What 3 key congressional hearings last week mean for the industry

    Political will seems to be rising to address drivers of growing medical costs and poor access to care, according to lawmaker comments on the Hill.

    By , May 19, 2023
  • Senator Richard Blumenthal sits in front of a poster illustrating Medicare Advantage coverage denials
    Image attribution tooltip
    Rebecca Pifer/Healthcare Dive
    Image attribution tooltip

    Senate scrutinizes MA payment denials, including use of algorithms

    “Insurers are in effect denying Americans necessary care in order to fatten and pad their bottom lines, and that phenomenon is unacceptable,” Sen. Richard Blumenthal, D-Conn., said at a subcommittee hearing.

    By May 18, 2023
  • Federal Trade Commission
    Image attribution tooltip
    Carol Highsmith. (2005). "The Apex Building" [Photo]. Retrieved from Wikimedia Commons.
    Image attribution tooltip

    FTC moves to strengthen Health Breach Notification Rule’s applicability to digital health apps

    Regulators are increasingly leaning on the HBNR to crack down on the sharing of sensitive medical data, and the FTC is looking to strengthen its case.

    By May 18, 2023
  • Federal Trade Commission
    Image attribution tooltip
    Carol Highsmith. (2005). "The Apex Building" [Photo]. Retrieved from Wikimedia Commons.
    Image attribution tooltip

    On heels of Amgen lawsuit, FTC broadens investigation of PBMs

    The regulator is probing the business practices of two more drug purchasing organizations, deepening an investigation that began last year.

    By Kristin Jensen • May 18, 2023
  • VA renegotiates tougher EHR modernization contract with Oracle Cerner

    The Department of Veterans Affairs said the new contract includes stronger performance metrics and larger credits to the VA if Oracle Cerner doesn’t meet expectations.

    By Emily Olsen • May 18, 2023
  • A wide camera angle of the U.S. Capitol in Washington, DC
    Image attribution tooltip
    Stefan Zaklin via Getty Images
    Image attribution tooltip

    House committee centers blame on PBMs for rising healthcare costs

    Conversation about pharmacy benefit management consolidation dominated the hearing, with lawmakers pointing to the middlemen as drivers of high health costs.

    By May 18, 2023
  • A stethoscope rests on a medical insurance claim form.
    Image attribution tooltip
    iStock / Getty Images Plus via Getty Images
    Image attribution tooltip

    Uninsured rate fell 18% during pandemic, CDC finds

    The findings reflect government subsidies aimed at boosting healthcare access during the pandemic, and requirements that states keep Medicaid beneficiaries on their rolls during the public health emergency.

    By Brian T. Horowitz • May 17, 2023
  • Detail view of the US Capitol east facade in the early morning sun.
    Image attribution tooltip
    drnadig via Getty Images
    Image attribution tooltip

    House Republicans target Biden admin over hospital price transparency noncompliance

    To improve price transparency, the government could consider extending reporting requirements to more provider sites or making compliance a condition of participating in Medicare, witnesses testified in a Tuesday hearing.

    By May 17, 2023
  • Close up shiny wooden law gavel in dark brown color on top of a wooden table in an office.
    Image attribution tooltip
    Stock Photo via Getty Images
    Image attribution tooltip

    Appellate court pauses ruling blocking ACA preventive care mandate

    The temporary administrative stay, which now legally requires health plans to provide preventive care for over 150 million Americans, applies while an appeal of the March case is considered by the court.

    By May 16, 2023
  • A birds-eye picture of a stethoscope and piggy bank against a blue background
    Image attribution tooltip
    erdikocak via Getty Images
    Image attribution tooltip
    Opinion

    Rethinking the area deprivation index: a call for more effective measures to promote health equity

    Srilekha Palle, visiting fellow at the Independent Women’s Forum, argues that a key health equity indicator used by the Biden administration has significant limitations that could exclude many underserved communities.

    By Srilekha Palle • May 12, 2023