Aetna settles HIV disclosure investigation for close to $650K

The multistate settlement stems from 2017 mailings that revealed some policyholders' HIV/AIDS or A-fib status.

By Meg Bryant • Oct. 15, 2018

Confronting pharma, Trump admin seeks price disclosure in drug ads

HHS chief Alex Azar announced the much-anticipated proposal Monday, dismissing a new pledge from trade lobby PhRMA as insufficient.

By Andrew Dunn • Oct. 15, 2018

Immigration rule change could force millions off Medicaid, report warns

The Trump administration is proposing a change to "public charge" policies that could also lead to higher costs for providers via uncompensated care and more ER visits, according to the Kaiser Family Foundation.

By Les Masterson • Oct. 15, 2018

States requiring hospitals provide more info on 340B drugs

Most states don't track 340B drug payments after rebates, but gaining that information could ultimately result in a change to reimbursement amounts.

By Les Masterson • Oct. 15, 2018

Grassley urges FTC to investigate hospital-payer contracts

The Senate Judiciary chairman is concerned that anticompetitive contracts could limit access to affordable care.

By Meg Bryant • Oct. 12, 2018

Massachusetts officials attach stiff conditions to Beth Israel-Lahey merger

The requirements follow a report warning the merger could result in a $128.4 million to $170.8 million spending increase for inpatient, outpatient and adult primary care services.

By Meg Bryant • Oct. 12, 2018

Average ACA premiums will drop for first time in 2019

Payers put through huge premium increases over the past two years, meaning next year's rates are likely a market correction.

By Les Masterson • Oct. 12, 2018

'Nowhere to hide' for rivals after blockbuster CVS-Aetna deal

The nearly $70 billion merger poses threats to providers as its scale and access to care aims to shift the healthcare dynamic in favor of consumers, BDO's David Friend told Healthcare Dive.

By Samantha Liss • Oct. 11, 2018

CMS touts more highly-ranked MA prescription plans next year

More than 36% of Medicare beneficiaries are expected to have Medicare Advantage plans in 2019.

By Les Masterson • Oct. 11, 2018

CMS bid to overhaul E/M codes leaves few happy

With its proposed changes to payments and documentation for office visits, the agency is effectively forcing providers to reckon with a longstanding, oft-disputed problem. 

By Tony Abraham • Oct. 10, 2018

Arkansas Medicaid work requirements beset by challenges, report finds

Most are unaware of the new rules or face major obstacles to complying, according to the Kaiser Family Foundation study. 

By Rebecca Pifer Parduhn • Oct. 10, 2018

Mayo, Geisinger among 1,300 providers signing up for BPCI-A

CMS announced the participants for its latest bundled payment model, including 832 acute care hospitals and 715 physician group practices.

By Les Masterson • Oct. 10, 2018

Wisconsin shelled out $1.1B for uncompensated care in FY17

Last year's cost for charity care and bad debt is a 14% increase from 2016.

By Rebecca Pifer Parduhn • Oct. 9, 2018

Health spending growth gap continues between public and private payers

The sector seems to be in a "post-recession, post-expanded coverage period of steady, moderate growth," according to a report from Altarum.

By Les Masterson • Oct. 8, 2018

More individual plans limit out-of-network care, report finds

Payers that still offer such coverage have shifted more costs to consumers, according to the Robert Wood Johnson Foundation. Narrow networks are less common in large employer plans.

By Les Masterson • Oct. 8, 2018

Payers find financial success in the ACA exchanges

Insurers have found footing after years of uncertainty, but risks remain.

By Les Masterson • Oct. 8, 2018

Hospitals give patients conflicting information on obtaining records, study finds

Some hospitals weren't in compliance when it came to the charges they required for the release of records and some didn't adhere to state requirements for processing times, according to a report in JAMA.

By Samantha Liss • Oct. 5, 2018

CMS to post more hospital accrediting information online

The agency said it will post care quality deficiency findings from complaint surveys, a list of providers the agency determines to be out of compliance and overall performance data for accrediting organizations.

By Shannon Muchmore • Oct. 5, 2018

New plans in Iowa don't offer pre-existing condition protections

Meanwhile, a federal judge scheduled a hearing on short-term health plans for Oct. 26. The plaintiffs filed a motion in September arguing those plans will harm the health insurance industry.

By Les Masterson • Oct. 5, 2018

CMS tweaks local coverage policy to speed access to medical devices

AdvaMed CEO Scott Whitaker said the agency's actions are commendable, but more should be done.

By David Lim • Oct. 5, 2018

CVS, Aetna defend merger potential to Connecticut regulators

The $69 billion deal is considered to have a good chance for approval. Aetna agreed last week to sell its standalone Medicare Part D business to help clear antitrust hurdles.

By Samantha Liss • Oct. 5, 2018

Health insurance premium growth exceeds wage increases, inflation

Employer-based single coverage deductibles rose 212% on average over the past decade, according to a report from the Kaiser Family Foundation.

By Les Masterson • Oct. 4, 2018

JAMA: Patients rated virtual visits better when given antibiotics

Researchers found that 72% of patients who didn't receive a prescription, 91% of those who received an antibiotic and 86% of those who received a nonantibiotic medication gave the doctor's visit the highest marks.

By Les Masterson • Oct. 4, 2018

Massachusetts nurse staffing mandate could cost nearly $950M annually

If the ballot question passes, hospitals in the state would have to hire as many as 3,100 additional full-time nurses to be in compliance, according to the Massachusetts Health Policy Commission.

By Tony Abraham • Oct. 4, 2018

Paratek eyes 800 key hospital accounts for new antibiotic's rollout

The pharma shed its clinical-stage title on Tuesday as the FDA approved Nuzyra along with another of its drugs.

By Jacob Bell • Oct. 4, 2018