Policy & Regulation
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Air ambulance advisory panel on surprise billing takes shape
The committee is tasked with reviewing and making recommendations to improve issues related to surprise billing, transparency around charges and fees, and insurance coverage.
By Samantha Liss • Sept. 13, 2019 -
Many people head to ER for quick care, poll finds
Baby boomers are less likely than their younger counterparts to head to the costlier site of care for non-emergency conditions.
By Linda Wilson • Sept. 12, 2019 -
Employers urged to get off sidelines to trim healthcare costs
"Healthcare is not their day job. They build ships. They stock groceries," the CEO of the Pacific Business Group on Health said. "But as costs go up, they're the ones paying it."
By Rebecca Pifer • Sept. 11, 2019 -
Without much choice on ACA exchanges, will star ratings matter?
The plan rankings are coming Nov. 1, but large swaths of the country have few carriers to choose from, raising questions about the usefulness of a rankings system.
By Samantha Liss • Sept. 11, 2019 -
Insurers to deliver whopping $1.3B in ACA consumer rebates
The record amount revealed in a Kaiser Family Foundation analysis reflects how profitable payers were over the past few years, largely fueled by plans in the individual market.
By Samantha Liss • Sept. 11, 2019 -
Back in session, Congress faces industry pushback on surprise billing
Intense lobbying by industry has taken its toll on the potential for a fix, once viewed as a promising field of action with bipartisan backing and even mention from President Donald Trump.
By Shannon Muchmore • Sept. 10, 2019 -
Medicare would negotiate prices for 250 drugs under House Democrats' plan
Speaker Nancy Pelosi's proposal also finds common ground with the president in pegging U.S. prices to an international index.
By Jonathan Gardner • Sept. 10, 2019 -
Uninsured rate rises for 1st time since ACA
The percentage of people with public coverage fell by 0.4 percentage points between 2017 and 2018 while the percentage of Americans with private coverage did not change, according to the the U.S. Census Bureau.
By Rebecca Pifer • Sept. 10, 2019 -
Low-margin rural hospitals far from next ER
Texas, New Mexico and Kansas had the most struggling rural hospitals, an analysis by the Center for American Progress found.
By Linda Wilson • Sept. 10, 2019 -
CHS hospital fined $85K in first HIPAA right of access case
The Office of Civil Rights began looking into the Florida hospital following a complaint from a woman seeking prenatal health records for her child.
By Rebecca Pifer • Sept. 09, 2019 -
MD Anderson official emerges as top choice to run FDA, reports say
Nominating Stephen Hahn, an oncologist and chief medical executive at the Texas cancer center, would be a change of course from acting agency head Ned Sharpless.
By Ned Pagliarulo • Sept. 09, 2019 -
Telemedicine CEO pleads guilty in $424M Medicare kickback scheme
The exec admitted to seeking and getting bribes from patient recruiters, pharmacies and brace suppliers in return for arranging for doctors to order medically unnecessary orthotic braces.
By Dana Elfin • Sept. 09, 2019 -
Medicaid expansion resulted in more ER visits, study finds
New Medicaid patients in states that expanded the program under the Affordable Care Act increased hospital visits on average by about 20%, according to new research from the Brookings Institution.
By Shannon Muchmore • Sept. 09, 2019 -
Kaiser to reveal detailed financials under newly signed California bill
As a not-for-profit operator, the giant health system previously was exempt from many of the state's reporting requirements.
By Rebecca Pifer • Sept. 06, 2019 -
CMS renews focus on catching fraudsters before they re-offend
The agency is beefing up its efforts to catch those that attempt to "reinvent" themselves after being banned from billing government programs.
By Ron Shinkman • Sept. 06, 2019 -
Hospitals should be in peer groups for CMS star ratings, study suggests
Provider groups have attacked the agency's ranking system since it debuted in 2005, saying the approach to measuring quality is overly simplistic and the presentation of the data is difficult for consumers to interpret.
By Linda Wilson • Sept. 05, 2019 -
AHA, Intel urge FCC to broaden rural telehealth pilot participation
Stakeholders from the healthcare, technology and communications sectors weighed in on the program aimed at increasing access to health services in rural areas.
By Dana Elfin • Sept. 04, 2019 -
Policies reducing price variations may produce savings, study suggests
Payers in Massachusetts could have saved a significant amount of money by steering patients to low-cost providers or setting a price ceiling, according to the research in Health Affairs.
By Linda Wilson • Sept. 04, 2019 -
Thousands who die awaiting kidney transplants rejected multiple organ offers: study
Although the quality of the organ was the primary reason for rejecting an offer, the study suggests the declined organs were suitable for the purpose of sustaining another human being.
By Ron Shinkman • Sept. 03, 2019 -
Deep DiveAmyloid's last hope? Prevention studies next big test for Alzheimer's research
The DIAN-TU trial, studying patients genetically predisposed to Alzheimer's, could help decide the fate of what's been the dominant hypothesis of the disease's cause.
By Jonathan Gardner • Aug. 29, 2019 -
Medicare paying hospices twice for drugs, OIG says
CMS should develop an oversight program with controls to identify and stop duplicate payments, the inspector general said.
By Linda Wilson • Aug. 29, 2019 -
Unblinded: Rebekah Gee's drug pricing experiment
Louisiana's health secretary negotiated a new payment model with Gilead for one of the poorest states in the country. Could it spread nationwide?
By Andrew Dunn • Aug. 28, 2019 -
Dozens of Select Medical LTCHs sue HHS over dual-eligible bad debt
The Provider Reimbursement Review Board refused to reimburse plaintiff hospitals' dual eligible bad debts involving 21 state Medicaid programs.
By Dana Elfin • Aug. 28, 2019 -
CMS updates Medicare Plan Finder following stakeholder pressure
The first iteration has been criticized by myriad stakeholder groups, including the Government Accountability Office, since its 1998 launch.
By Rebecca Pifer • Aug. 27, 2019 -
Trump admin: Immigrant sponsors' income a factor in Medicaid eligibility
Despite vocal opposition to the public charge rule, industry players like the AHA and AHIP have not taken public positions yet on the eligibility requirements for immigrants.
By Samantha Liss • Aug. 26, 2019
