Government: Page 104
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Price transparency proposals raise thorny questions
One hospital CEO is bucking the trend and embracing price disclosure, but the effectiveness of such requirements is unclear.
By Samantha Liss • June 7, 2019 -
CMS calls for ideas to cut red tape
Federal health regulators want to reduce the administrative burden and "needless paperwork" baked in the system and they're asking the public to submit ideas.
By Samantha Liss • June 7, 2019 -
Alex Wong via Getty Images
Industry cheers spirit but not fine print in HHS interoperability rules
The comment period of two wide-ranging regulations to promote interoperability in healthcare closed Monday night. Here's what industry's biggest players had to say.
By Rebecca Pifer Parduhn • Updated June 5, 2019 -
Utah wants capped Medicaid enrollment, spending
In a new demonstration waiver, the state proposes capping the growth rate of federal payments for its limited Medicaid expansion at the rate of medical inflation, rather than the usual, lower rate of consumer price inflation.
By Rebecca Pifer Parduhn • June 3, 2019 -
ONC exploring ways to streamline electronic prior authorization
The HHS IT chief criticized the current state of electronic prior authorization at Academy Health's conference Monday, calling it a "non-computerized kabuki of payment" that "needs to get rethought."
By Rebecca Pifer Parduhn • June 3, 2019 -
In win for hospitals, Supreme Court rules DSH change violated law
The nation's highest court, in a 7-1 opinion, vacated an HHS policy that would have cut reimbursement to hospitals with high shares of low-income patients, saying the government did not follow proper procedures in issuing the policy.
By Dana Elfin • June 3, 2019 -
What's at stake in CVS-Aetna merger hearing: 4 questions
Judge Richard Leon will hear testimony from proponents and opponents of DOJ's settlement agreement with CVS and Aetna at what is shaping up to be a contentious hearing starting Tuesday in federal court.
By Dana Elfin • June 3, 2019 -
Getty Images / Edited by Supply Chain Dive
In disaster response, health supply chain egos melt away
A speedy post-hurricane return to normal requires competitors to become collaborators to effectively manage inventory and cold chains.
By Gary Wollenhaupt • June 3, 2019 -
DOJ loses bid to change contours of CVS-Aetna settlement hearing
The government argued the procedures for the three-day hearing set to start next week needed to be modified but the judge rejected the bid late Thursday, calling it an "eleventh-hour request to reshape next week's hearing."
By Dana Elfin • Updated May 31, 2019 -
Safety net hospitals fall behind in Medicare joint replacement model
The results could be because of inferior, higher-cost care from safety net hospitals or because the program "does not account for the increased social vulnerabilities of patients" in those facilities, the study authors wrote.
By Shannon Muchmore • May 29, 2019 -
Seniors' out-of-pocket spending on cancer drugs continues to climb
Despite efforts to limit Medicare Part D beneficiaries' financial exposure to high-cost drugs, price increases have wiped out some of the expected savings.
By Samantha Liss • May 29, 2019 -
US healthcare spending estimated to grow to $3.6T this year
Fitch Solutions anticipates a 4% growth rate, below a CMS forecast from earlier this year but still driven heavily by Medicare. Private insurance is not expected to be a primary contributor to spending growth.
By Tony Abraham • May 29, 2019 -
Senate health committee takes on surprise bills, price transparency in legislative package
The American Hospital Association said it was "concerned about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers."
By Shannon Muchmore • May 24, 2019 -
Novartis gene therapy approved, but will come at cost of more than $2M
Zolgensma is designed to be a cure for spinal muscular atrophy, but its steep price will pose difficulties for a system designed for chronic therapy rather than one-time treatments.
By Ned Pagliarulo • Updated May 24, 2019 -
CMS home-based primary care model yields mixed results
The model had some success in lowering Medicare expenditures over the four-year term but resulted in significantly higher spending, according to an outside analysis.
By Rebecca Pifer Parduhn • May 24, 2019 -
AHA argues nonprofit hospitals more than make up for lost tax revenue
Tax-exempt facilities are under scrutiny, and, in some cases, caught up in litigation over their status and the perks that come with it.
By Shannon Muchmore • May 23, 2019 -
ONC advisory committee finalizes interoperability rule recommendations
The group is recommending a two-tier payment system to help health IT vendors recoup costs associated with making their systems interoperable.
By Rebecca Pifer Parduhn • May 23, 2019 -
Industry groups square off on surprise billing
A Congressional hearing on the topic Tuesday came after President Donald Trump highlighted the issue earlier this month and called for a bipartisan solution that protects patients in all insurance markets.
By Shannon Muchmore • May 22, 2019 -
Show me the evidence, judge tells short-term health plan rule challengers
The government and patient advocate groups faced off in court over a final rule expanding access to short-term health insurance plans. A ruling is not expected until later this summer.
By Dana Elfin • May 22, 2019 -
More practices open to downside risk, AMGA finds
But practices listed a number of barriers to the ongoing transition to value-based payments, including lack of access to administrative claims data and physician compensation issues, according to the survey.
By Shannon Muchmore • May 22, 2019 -
Wyden introduces price transparency bill targeting payers
The legislation stipulates that commercial insurers, as well as Medicare plans, provide an online tool and toll-free phone number for members to ask about cost of services and quality of providers.
By Shannon Muchmore • May 17, 2019 -
CMS pulls back on key Part D proposals
While the final rule is seen as a win for pharmas and insurers, pharmacists and drugstores were not pleased.
By Samantha Liss • Updated May 20, 2019 -
Small PBMs urge Congress: Don't kill rebates
An HHS rule that would eliminate Medicare and Medicaid drug rebates could have the unintended effect of raising patients' drug costs, one executive said.
By Samantha Liss • May 16, 2019 -
CMS targets PBM spread pricing
The agency is concerned the practice of charging pharmacists and health plans different prices for the same drugs is inflating costs and increasing the burden on taxpayers.
By Samantha Liss • May 16, 2019 -
Federal lawmakers put forward competing proposals to ban surprise billing, with key difference
Both bills are bipartisan, but a draft bill in the House does not include arbitration, while the Senate plan does. The American Hospital Association supports such a provision, while the payer lobby group strictly opposes it.
By Shannon Muchmore • Updated May 16, 2019
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