Government: Page

  • payments fraud Senate scams Mike Crapo
    Image attribution tooltip
    Andrew Harnik via Getty Images
    Image attribution tooltip

    Crapo, Wyden to reintroduce bipartisan PBM package

    Republicans and Democrats couldn’t be further apart on how to address the looming ACA affordability cliff. But there seems to be a path forward on curbing pharmacy benefit managers.

    By • Nov. 20, 2025
  • Text of the word 'Medicaid' in the middle of a U.S. dollar bill
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    Urban safety-net hospitals vulnerable to Medicaid cuts: analysis

    Though the impact on rural facilities has received more focus from lawmakers, the majority of hospitals that are most susceptible to the funding cuts operate in urban communities, according to the report.

    By Emily Olsen • Nov. 19, 2025
  • Stethoscope on bill statement. Explore the Trendline➔
    Image attribution tooltip
    Getty Images
    Image attribution tooltip
    Trendline

    Surprise Billing

    Federal legislation banning surprise bills has hit a barrage of roadblocks, complicating efforts to protect consumers from unexpected out-of-network charges.

    By Healthcare Dive staff
  • The U.S. Capitol stands in the distance as morning traffic moves along North Capitol Street Northwest on October 01, 2025 in Washington, DC. The government shut down early Wednesday after Congress failed to reach a funding deal.
    Image attribution tooltip
    Chip Somodevilla / Staff via Getty Images
    Image attribution tooltip

    Republican antipathy during key Senate hearing darkens outlook for ACA subsidy extension

    More generous subsidies for Affordable Care Act plans have helped millions of Americans afford insurance. Chances are becoming slimmer that the assistance will survive the year.

    By • Nov. 19, 2025
  • A picture of a form that says 'Medicaid eligibility'
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    States project flat Medicaid enrollment, increased spending as cuts loom: KFF

    Total spending in the safety-net insurance program is expected to grow 7.9% in fiscal year 2026, according to the survey. Meanwhile, states are facing significant federal cuts in the wake of the One Big Beautiful Bill Act.

    By Emily Olsen • Nov. 18, 2025
  • a medicaid insurance card on top of a small American flag
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    CMS issues guidance on Medicaid provider tax overhaul

    The agency has started to lay out how it’ll implement restrictions on the arrangements, which are used by states to finance their share of Medicaid funding, enacted in the One Big Beautiful Bill Act.

    By Emily Olsen • Nov. 17, 2025
  • Medicare enrollment form and money.
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    Medicare premiums set to rise 10% next year, CMS says

    The Part B premium hike could have been worse, the Trump administration said. Still, it’s likely to pressure the pocketbooks of millions of seniors, and could drive more into Medicare Advantage plans.

    By • Nov. 17, 2025
  • A group of people around President Donald Trump, who holds up a signed bill.
    Image attribution tooltip
    Win McNamee via Getty Images
    Image attribution tooltip

    Telehealth flexibilities reinstated as government shutdown ends

    The pandemic-era virtual care policies are back in place through Jan. 30. But short-term deals aren’t sustainable, telehealth advocates and providers say.

    By Emily Olsen • Nov. 13, 2025
  • an exterior view of the US Capitol building
    Image attribution tooltip
    Joe Raedle via Getty Images
    Image attribution tooltip

    Historic government shutdown ends, leaving ACA subsidies in limbo

    The House passed a stopgap funding bill and President Donald Trump signed it after a weeks-long impasse, reopening the government without a clear path forward on preserving enhanced subsidies for ACA plans — Democrats’ chief demand.

    By • Nov. 13, 2025
  • FDA sign
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    Richard Pazdur, longtime FDA oncology leader, to head agency’s main drug office

    The appointment of Pazdur as CDER head comes shortly after the surprise ousting of George Tidmarsh and should quiet many of the “lingering uncertainties” surrounding the FDA, wrote one industry analyst.

    By Kristin Jensen • Nov. 12, 2025
  • A person in a business suit gestures while speaking from a chair.
    Image attribution tooltip
    Tasos Katopodis via Getty Images
    Image attribution tooltip

    FDA to remove safety warnings on hormonal menopause therapy

    The decision, issued without the input of an official advisory committee, revises long-held labeling on the drugs cautioning the risk of cancer and heart disease.

    By • Nov. 10, 2025
  • A man speaks at a podium.
    Image attribution tooltip
    Andrew Harnik via Getty Images
    Image attribution tooltip

    Indiana approves controversial hospital merger despite FTC protests

    Union Hospital and Terre Haute Regional are set to merge after getting the green light from Indiana’s health department over the objections of federal regulators in two administrations and the state’s own attorney general.

    By • Nov. 10, 2025
  • A stethoscope resting on a stack of white papers
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    Democrats introduce bill to repeal Medicare prior authorization pilot

    Lawmakers argue the CMS innovation center pilot, which will implement AI-backed prior authorization for some services in six states, will add red tape and limit access to care.

    By Emily Olsen • Nov. 10, 2025
  • The U.S. capitol building stands in front of a blue sky.
    Image attribution tooltip
    Win McNamee via Getty Images
    Image attribution tooltip

    Congress inches towards ending shutdown with no extension of ACA subsidies

    The Senate overcame a key procedural hurdle on Sunday after eight Democrats broke with their party to back a measure freeing the government from the longest funding lapse in history.

    By • Nov. 10, 2025
  • Medicine pill on 100 dollar banknote background
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    CMMI to launch model to lower Medicaid drug spending

    Under the model, set to start next year, the CMS will negotiate lower prices for Medicaid programs linked to those paid in select other countries.

    By Emily Olsen • Nov. 7, 2025
  • David Ricks, CEO of Eli Lilly, speaks alongside U.S. President Donald Trump, administration officials and fellow pharmaceutical executives on November 06, 2025 in Washington, DC.
    Image attribution tooltip
    Andrew Harnik via Getty Images
    Image attribution tooltip

    Novo, Lilly cut deal with Trump to lower prices of obesity drugs

    The agreement will make Wegovy and Zepbound available to some Medicare enrollees for $245 per month, and starter doses of pill versions, once approved, for $149 monthly.

    By Jonathan Gardner • Nov. 6, 2025
  • Shot of an unrecognizable person on a videocall with a doctor - stock photo
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    Telehealth groups urge Congress to adopt long-term virtual care fix

    More than 450 telehealth and provider organizations are pushing lawmakers to avoid another temporary extension of telemedicine flexibilities amid a historic government shutdown.

    By Emily Olsen • Nov. 6, 2025
  • CMS Administrator Dr. Mehmet Oz speaks at an Aspen Institute event.
    Image attribution tooltip
    Permission granted by Aspen Institute
    Image attribution tooltip

    Legislators object to proposed CMS payment changes for diabetes tech

    In a letter to CMS Administrator Dr. Mehmet Oz, diabetes caucus leaders raised concerns that the agency’s proposals will reduce access to glucose monitors and insulin pumps.

    By Elise Reuter • Nov. 4, 2025
  • A sign notes that the U.S. Capitol Visitor Center is closed due to the government shutdown, with the capitol building in the background.
    Image attribution tooltip
    Al Drago via Getty Images
    Image attribution tooltip

    Health groups urge passage of bill to ease Medicare pay cuts for tests

    More than 30 organizations, including AdvaMed and the American Clinical Laboratory Association, are pushing for a permanent legislative solution to stop looming Medicare payment cuts for diagnostic tests.

    By Susan Kelly • Nov. 3, 2025
  • The HHS in DC
    Image attribution tooltip
    Alex Wong via Getty Images
    Image attribution tooltip

    Medicare finalizes controversial cut to specialty care next year

    The CMS finalized the Medicare physician fee schedule for 2026 one day before the statutory deadline. It includes an overall payment hike and a few policies that are deeply unpopular with specialists.

    By • Updated Nov. 4, 2025
  • A calculator and stethoscope rest on a medical bill.
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    Federal ACA enrollment kicks off without action on subsidies

    Millions of Americans are facing steep price hikes for Affordable Care Act coverage while Congress dithers over the issue. Experts say there’s not as much time to act as legislators may believe.

    By • Nov. 1, 2025
  • Various pill bottles stand arranged on a pharmacy shelf.
    Image attribution tooltip
    IPGGutenbergUKLtd via Getty Images
    Image attribution tooltip
    Opinion

    New CBO report confirms 340B’s ballooning costs. Congress must act.

    Former Congressional Budget Office Director Dan Crippen argues the 340B discount program is overdue for reform.

    By Dan Crippen • Oct. 31, 2025
  • Medicine pill on 100 dollar banknote background
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    HRSA approves 340B rebate models to hospitals’ chagrin

    Drugs that will be subject to rebates in 340B next year include Bristol Myers Squibb’s Eliquis, Johnson & Johnson’s Stelara and Novo Nordisk’s Novolog.

    By • Oct. 31, 2025
  • man in a dark blue suit speaks in the oval office
    Image attribution tooltip
    Anna Moneymaker via Getty Images
    Image attribution tooltip

    FDA, aiming to lower drug costs, moves to speed approval of biosimilars

    The agency will no longer require studies comparing copycat biologics to their branded counterparts, which could help developers bring them to market more quickly and cheaply. 

    By Jonathan Gardner • Oct. 29, 2025
  • The exterior of the U.S. Capitol on Jan. 3, 2024.
    Image attribution tooltip
    Colin Campbell/Healthcare Dive
    Image attribution tooltip

    Senators show bipartisan support for reforming 340B during HELP hearing

    Lawmakers called for more transparency about how hospitals are using 340B revenue, including audits of participating facilities. 

    By Susanna Vogel • Oct. 24, 2025
  • The HHS in DC
    Image attribution tooltip
    Alex Wong via Getty Images
    Image attribution tooltip

    CMS calls back furloughed employees to help with Medicare, ACA enrollment periods

    Roughly 3,000 employees went back to work on Monday, funded by user fees as the shutdown drags into its fourth week.

    By • Oct. 24, 2025