Government: Page 103
-
Elizabeth Regan/Healthcare Dive
Drugmakers will soon be required to disclose prices in TV ads
Forcing pharma's hand, the Trump administration finalized a proposal requiring list prices in direct-to-consumer advertising, a move that could result in a legal challenge from industry.
By Ned Pagliarulo • May 8, 2019 -
Payers had best individual market performance in 2018 since ACA began
A Kaiser Family Foundation analysis on the profitability of the ACA individual market also found insurers expect to pay a record amount of rebates to consumers for not meeting the medical loss ratio threshold in 2018.
By Rebecca Pifer Parduhn • May 8, 2019 -
Kaiser Permanente rolls out EHR-integrated program to tackle social determinants of health
The social health network, a partnership with Unite Us, will be available within three years to all 12.3 million Kaiser Permanente members and the communities it serves, the health system said.
By Meg Bryant • May 7, 2019 -
CMS interstate insurance idea rebuffed by payers, state regulators
Commenters advised the agency against further policymaking on the issue, arguing it could invite a "race to the bottom" that only stands to benefit insurers.
By Tony Abraham • May 7, 2019 -
HHS officials defend interoperability rules to Senate critics
"To the extent this is delayed or prevented, the American public is not in control of their healthcare," the Office of the National Coordinator for Health IT head Don Rucker warned.
By Rebecca Pifer Parduhn • May 7, 2019 -
Seniors switching to MA already have lower costs than traditional Medicare beneficiaries
A new Kaiser Family Foundation study raises questions about whether MA payment rates, which are based on spending for similar people in traditional Medicare, are too high.
By Rebecca Pifer Parduhn • May 7, 2019 -
CMS draft guidance clarifies hospital co-location policy
The American Hospital Association has repeatedly urged the agency to make its policy clear, noting some hospitals were dismantling co-location and shared service arrangements out of concern they would be found noncompliant.
By Meg Bryant • May 6, 2019 -
Medicare drug rebate ban not magic balm, federal budget forecasters say
The Trump administration plan to eliminate certain drug rebates in Medicare would increase federal spending by $177 billion over a decade, the CBO found.
By Jonathan Gardner • May 3, 2019 -
Taylor McKnight/Healthcare Dive
CBO wades into 'Medicare for All' debate, sidesteps landmines for now
Providers and payers seized on the report to cement their opposition to single-payer policies, but the government agency avoided analysis of any specific plan.
By Tony Abraham • May 2, 2019 -
AHA asks for antitrust probe of Centene-WellCare deal
While Centene CEO Michael Neidorff has downplayed antitrust concerns over the deal, he acknowledged to investors last week that divestitures are likely, specifically in Nebraska and Missouri.
By Shannon Muchmore • May 2, 2019 -
Trump administration asks appeals court to toss entire ACA
DOJ urged the Fifth Circuit to uphold a trial court's ruling finding the law unconstitutional, marking a change for the government, which had previously said the remainder of the ACA was severable from its individual mandate.
By Dana Elfin • May 2, 2019 -
CMS seeks comments on state workarounds to ACA requirements
The agency has gradually pushed states to consider more so-called innovation waivers that can allow them to sidestep key tenets of the ACA in their health insurance markets.
By Rebecca Pifer Parduhn • May 2, 2019 -
CMS wants notice of ownership changes at accrediting organizations
The proposed rule follows the agency's drive to strengthen its oversight of accrediting organizations.
By Samantha Liss • April 30, 2019 -
More Medicaid insurers could be ticket to lowering premiums in ACA markets
An Urban Institute and Robert Wood Johnson Foundation report shows a correlation between states with lower premiums and broad Medicaid managed care coverage within the state.
By Meg Bryant • April 30, 2019 -
Alex Wong via Getty Images
HHS curbs fines for HIPAA violations
A new legal interpretation of the act would cut the annual ceiling for a fine from $1.5 million and move to a tiered system, depending on violation severity.
By Rebecca Pifer Parduhn • April 29, 2019 -
Deductibles soar in small business health insurance market
Small companies are turning to plans with restricted provider networks as a way to contain healthcare costs, insurance broker eHealth found.
By Les Masterson • April 29, 2019 -
ACA could cushion payers during next recession: Moody's
While health insurers wouldn't be able to avoid taking a hit from lower employment levels, the rating agency's research shows Medicaid expansions and the ACA exchanges create protections the companies didn't have in 2008.
By Tony Abraham • April 26, 2019 -
FTC accuses Surescripts of monopolizing e-prescribing markets
The commission alleges the health IT vendor, owned by some of the biggest PBMs and pharmacies, used exclusivity agreements and threats to stop customers from using other platforms.
By Shannon Muchmore • April 25, 2019 -
CMS urges state Medicaid programs to test new dual eligible care models
The agency lamented the lack of care coordination for the dual eligible population that leads to "misaligned incentives for payers and providers, and administrative inefficiencies and programmatic burdens for all."
By Les Masterson • April 25, 2019 -
Hospitals, doctors and Gawande laud new CMS primary care model, but will practices stay?
The agency set an ambitious goal of enrolling a quarter of all traditional Medicare fee-for-service providers and beneficiaries in the new model. The program, however, is voluntary, and some paths carry significant downside risk.
By Shannon Muchmore • April 24, 2019 -
Medicare proposes raising CAR-T pay, but reimbursement solution years away
As new technologies nip at CAR-T's heels, CMS could take three years to develop a separate reimbursement category for Novartis' Kymriah and Gilead's Yescarta.
By Jonathan Gardner • April 24, 2019 -
CMS proposes wage index change to help prop up rural hospitals
The agency's proposed inpatient payment system rule would boost hospital Medicare payments by about 3.7%, which Jefferies noted was the largest increase in a decade.
By Tony Abraham • April 24, 2019 -
Half of middle-income seniors won't be able to afford healthcare, housing in a decade
Over the next decade, 60% of seniors will have mobility limitations and 20% will have high healthcare needs, according to a new study published in Health Affairs. And that's just the tip of the iceberg.
By Rebecca Pifer Parduhn • April 24, 2019 -
Graying doctors, patients to fuel 122K physician shortage by 2032, AAMC warns
The Association of American Medical Colleges also notes that healthcare delivery trends such as better care coordination, value-based contracting and more advanced practice providers will cut demand for physicians by only 1%.
By Les Masterson • April 24, 2019 -
Data breach at physician staffing firm EmCare hits 31K patients
Unauthorized email access exposed patient, employee and contractor personal information, such as name, date of birth or age and patient clinical data, the company said.
By Les Masterson • April 23, 2019
Previous
