Government: Page 100
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CMS to delay star ratings update pending expert panel review
The agency will convene an expert panel to look at the star ratings system, which is deeply unpopular with providers, and decide whether it's due for a facelift.
By Rebecca Pifer Parduhn • July 12, 2019 -
Plaintiffs in ACA lawsuit may not have exchange plans. Could that derail the entire challenge?
The two men claim the individual mandate forces them to buy expensive insurance. But they may no longer have minimum essential coverage, raising questions about whether they have standing in the high-profile case.
By Samantha Liss • July 12, 2019 -
Deep Dive
ACA's legal jeopardy: 4 questions
The embattled landmark law is again before jurists, this time a panel of the Fifth Circuit Court of Appeals. Arguments this week offered more insight into what's at stake.
By Shannon Muchmore , Samantha Liss , Dana Elfin • July 11, 2019 -
FCC approves rural telehealth pilot
The three-year, $100 million program would give an 85% discount on connectivity for broadband-enabled telehealth services that directly connect doctors and patients.
By Shannon Muchmore • July 11, 2019 -
Appeals court judge on ACA: 'Congress can fix this'
Two Republican-appointed judges hammered Democrats on whether the ACA's individual mandate was severable from the rest of the law and asked why Congress expected them to find a solution.
By Samantha Liss , Dana Elfin • July 10, 2019 -
Air ambulance industry on defense as surprise billing debate heats up
Emergency air service providers are warning of base closures if surprise billing legislation working its way through Congress passes.
By Samantha Liss • July 10, 2019 -
Trump executive order seeks to overhaul US kidney care
The government push for home dialysis will help major payers like UnitedHealth Group, Cigna, Anthem and Humana and interested companies like CVS Health move into the space.
By Rebecca Pifer Parduhn • Updated July 10, 2019 -
In win for pharma, Trump TV drug price rule struck down
The federal district court sided with a drugmaker coalition that argued the government overstepped its authority in trying to force price transparency in advertisements.
By Jonathan Gardner • July 9, 2019 -
Pharma stocks slide as industry mulls Trump drug price action
Drug pricing is back in the spotlight as politicians grapple with ways to bring down healthcare costs. While the meaning of the president's comments wasn't clear, Monday's market reaction was unambiguous.
By Ned Pagliarulo • July 9, 2019 -
Healthcare Dive's 10 biggest stories of the spring
From Amazon pushing into the prescription delivery sector to CVS-Aetna struggling to finalize their merger settlement agreement, read the top stories from the first half of the year.
By Rebecca Pifer Parduhn • July 8, 2019 -
Air Methods, Global Medical Response most at risk with surprise billing ban
Large air ambulance companies have the most to lose should a ban on balance billing become law, a new report says.
By Ron Shinkman • July 8, 2019 -
Doctors significantly over-allocated times to perform joint replacements, study shows
Time periods estimated to perform medical procedures, known as relative value units, are crucial for determining how much surgeons and other doctors are paid for their work under the Medicare Physician Fee Schedule.
By Ron Shinkman • July 3, 2019 -
ACOs may need stronger financial incentives, like downside risk, to succeed
The proportion of ACOs taking downside risk has inched up in recent years but still represents a minority, a study published in Health Affairs found.
By Rebecca Pifer Parduhn • July 3, 2019 -
Air ambulance charges soar over most other providers
A new study in Health Affairs examines the price air ambulances charge Medicare, an important figure that reveals the potential financial exposure some patients may face if they receive a surprise, out-of-network bill.
By Samantha Liss • July 1, 2019 -
Hospitals saved $1K per episode under joint replacement bundled model
Most participating hospitals received reconciliation payments in at least one of the program's first two years. Those getting the bonus tended to have higher quality scores, more episodes of care and lower patient complexity.
By Shannon Muchmore • July 1, 2019 -
Deep Dive
Once 'bodies for hire,' CROs are finding a new role as data specialists
Drugmakers and regulators are paying more attention to what real-world data can prove — driving demand for contract research providers to help keep up.
By Jacob Bell • June 28, 2019 -
Hospital groups argue CMS wage index proposal flawed
Providers generally approve of the attempt to prop up rural hospitals with a change to the wage index but most don't agree with the redistribution method the agency suggested earlier this year.
By Shannon Muchmore • June 27, 2019 -
Aiming for price transparency, Civica Rx hits snag with bundled payments
The payment model, often opaque on specific drug costs, affects many of the medicines the hospital-led group is targeting, according to commercial chief Heather Wall.
By Jacob Bell • June 27, 2019 -
CMS clears Louisiana Medicaid 'Netflix model' for hep C drugs
The subscription model will go into effect Monday, coming after the state inked a five-year partnership with a Gilead subsidiary to manufacture the treatment.
By Rebecca Pifer Parduhn • June 26, 2019 -
Left-leaning think tank highlights 'high price of hospital care'
Acute care hospitals had total margins of nearly 8% in 2016, the highest in more than a decade and above profits for pharmacies, payers and pharmacy benefit managers, according to the Center for American Progress.
By Shannon Muchmore • June 26, 2019 -
Deep Dive
Hospital price transparency push draws industry ire, but effects likely limited
While few would argue for secrecy for its own sake, policy analysts say there's little evidence patients use the information now available to make decisions that could bend the cost curve.
By Shannon Muchmore • June 25, 2019 -
Supreme Court to hear $12B risk corridor case next term
The Chamber of Commerce urged the court to take the case, warning that if the government is allowed to renege on its promised payments it could scare off the business community from working with the government.
By Dana Elfin • June 25, 2019 -
Trump order to force hospitals to reveal information behind negotiated rates
Providers and payers will be required to give patients estimates for out-of-pockets costs for procedures in advance under an executive order the president is expected to sign Monday. A legal challenge is likely.
By Shannon Muchmore • June 24, 2019 -
Surprise billing fixes would ding hospitals, staffing companies, Moody's says
Legislative proposals to end the practice of surprise billing are mostly credit negative for providers, but fixes that include bundled billing or an in-network guarantee would have the worst effect.
By Rebecca Pifer Parduhn • June 21, 2019 -
Deep Dive
Industry interoperability concerns plague TEFCA draft
ONC's "on-ramp" to nationwide connectivity is being dogged by many of the same issues as its interoperability regulations, including implementation, standardization and privacy.
By Rebecca Pifer Parduhn • June 20, 2019
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