Government: Page 110
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Brian Tucker/Healthcare Dive
Pharma's day in Congress: 'A hearing not a show'
Lawmakers indicated PBMs should be ready for scrutiny as well, with Sen. Ron Wyden, D-Ore., ranking member of the Finance Committee, saying they "are going to have their day in front of the committee, too."
By Ned Pagliarulo , Andrew Dunn • Feb. 26, 2019 -
VA offers updated criteria for getting care at outside hospitals
If finalized, the proposal would allow veterans to receive comparable care at non-VA facilities, though some critics fear a slippery slope toward privitization.
By Les Masterson • Feb. 25, 2019 -
ONC's sights trained on interoperability, data security, advisory committee says
Interoperability "remains fragmented and uneven" in the healthcare industry, according to a draft update from ONC's Health Information Technology Advisory Committee.
By Meg Bryant • Feb. 22, 2019 -
Partial Medicaid expansion would increase uninsured rate, federal costs
A few states that haven't expanded the program under the ACA, including Utah and Georgia, are looking at partial expansion plans in an attempt to cut costs.
By Les Masterson • Feb. 22, 2019 -
UPMC fires back at state AG, seeks to join BCBS antitrust lawsuit
The flurry of filings taps into big questions over payer competition and underscores tensions between insurance companies and providers as they negotiate contracts, especially in highly concentrated markets.
By Tony Abraham , Samantha Liss • Updated March 19, 2019 -
USDA
1 in 5 rural hospitals at risk of closing, Navigant says
More than 60% of those facilities are "highly essential" to the heath and economic well-being of their communities, according to a new report.
By Meg Bryant • Feb. 21, 2019 -
Hospitals oppose fixed payments in any laws tackling surprise billing
Meanwhile, a new analysis shows that about one in five emergency department visits involve an out-of-network provider and could result in a surprise bill.
By Shannon Muchmore • Feb. 21, 2019 -
Getty / Edited by Healthcare Dive
CHS tops Q4 expectations with revenue boost
The Tennessee chain, which is nearing its divestiture goal, incurred losses from a drop in volume and increased operational costs.
By Tony Abraham • Feb. 21, 2019 -
US healthcare spending growth to hit 5.5% by 2027, CMS predicts
The ballooning American healthcare bill will outstrip growth of the GDP over the next decade, according to an annual government report.
By Rebecca Pifer Parduhn • Feb. 20, 2019 -
Seniors love Medicare, but are pessimistic about its long-term future
One-third of responders to eHealth's Medicare Consumer Survey said when choosing a plan, an affordable monthly premium is the most important consideration.
By Les Masterson • Feb. 20, 2019 -
Insurers owed CSR payments regardless of silver loading, judges rule
In one of the lawsuits, a judge wrote the payer "should not be left 'holding the bag' for taking our Government at its word."
By Shannon Muchmore • Feb. 19, 2019 -
DOJ sticking with CVS-Aetna merger pact despite negative public comments
The agreement, which required Aetna to divest all of its Medicare Part D business, "fully addresses the competitive threat posed by the merger," the department said.
By Samantha Liss • Feb. 19, 2019 -
More primary care physicians linked to lower mortality
There were more primary care doctors in 2015 than 2005, but not in the areas that needed them most, according to a JAMA Internal Medicine study.
By Les Masterson • Feb. 19, 2019 -
CMS emergency transport model supports telehealth, non-hospital venues
The five-year demonstration project — scheduled to kick off early next year — also encourages the creation of medical triage lines for low-acuity 911 calls.
By Meg Bryant • Feb. 15, 2019 -
Charitable enough? UPMC case highlights increased scrutiny of nonprofit hospitals
"I think the bottom line is: The AG is not going to be satisfied with a duopoly in which one firm is clearly dominant and is going to be able to have its way," said Tim Greaney, former assistant chief in the DOJ's antitrust division.
By Tony Abraham , Samantha Liss • Feb. 15, 2019 -
Partners-CNE deal won't get thorough review in Massachusetts
The state's health policy commission reported Partners' acquisition of Care New England will not affect competition or set back care access because of the health systems' different patient populations and geographies.
By Les Masterson • Feb. 15, 2019 -
HIMSS19: CMS innovation center could jumpstart interoperability models
CMMI chief Adam Boehler said Wednesday the industry could expect such proposals as soon as the next few months, but that any such models could be staggered across participants, types and time.
By Rebecca Pifer Parduhn • Feb. 14, 2019 -
Accrediting group updates widely used quality metrics
Medicare Advantage plans use NCQA quality metrics to measure the performance within their provider networks, any changes to those measures will be closely watched as MA plans now cover 22.4 million seniors.
By Meg Bryant • Feb. 14, 2019 -
HIMSS19: CMS plans to host AI challenge, innovation chief says
The goal of the initiative is to spur private interest in the tech, improve the government's grasp on healthcare data, eliminate unnecessary care and cut costs, Adam Boehler said.
By Rebecca Pifer Parduhn • Feb. 14, 2019 -
California county pushes ahead with purchase of Verity hospitals despite AG opposition
Verity filed for bankruptcy in August. Last month, a judge denied California Attorney General Xavier Becerra's petition to block the sale of the two hospitals, citing lack of standing.
By Meg Bryant • Feb. 14, 2019 -
HIMSS19: Grassley presses CMS on recovery of improper EHR incentive payments
CMS Administrator Seema Verma told Healthcare Dive she continues to monitor efforts to recover the improper payments, but noted they occurred prior to President Donald Trump taking office.
By David Lim • Feb. 13, 2019 -
Deep Dive
HIMSS19: Private sector catch-up, patient matching and standard APIs dominate first full day
Support for the HHS rules (but some concern over implementation) was the focus at the start of health IT's biggest week.
By Rebecca Pifer Parduhn • Feb. 13, 2019 -
HIMSS19: Verma touts Blue Button 2.0 apps, though uptake still low
Only a few thousand Medicare beneficiaries have elected to share their claims data with production developers, the CMS administrator said.
By David Lim • Feb. 13, 2019 -
HIMSS19: New API coming for Medicare ACOs
The application programming interface builds off Medicare fee-for-service's API, Blue Button 2.0, but is much wider in scope.
By Rebecca Pifer Parduhn • Feb. 13, 2019 -
Provider groups wary of major changes to HIPAA
In response to an HHS request for information, AHA, AMA and others urged maintaining the status quo when it comes to potential amendments to the privacy law to better accommodate for value-based payment models.
By Shannon Muchmore • Feb. 13, 2019
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