Government

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 Rebecca Pifer • June 27, 2022

'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 Shannon Muchmore • June 24, 2022

Explore the 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

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 Hailey Mensik • June 24, 2022

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 Sydney Halleman • June 24, 2022

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 Rebecca Pifer • 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

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 Sydney Halleman • June 22, 2022

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

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 Rebecca Pifer • June 21, 2022

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

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

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

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

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 Shannon Muchmore • June 15, 2022

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 Samantha Liss • June 14, 2022

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

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 Rebecca Pifer • June 13, 2022

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

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 Rebecca Pifer • June 13, 2022

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 Samantha Liss • June 9, 2022

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 Rebecca Pifer • June 9, 2022

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 Samantha Liss • June 8, 2022

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 Rebecca Pifer • June 7, 2022

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 Samantha Liss • 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