Government: Page 130
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Physician practices seek help in transition to value-based care
A new report found physicians are moving more toward independent and physician-led group practices after a six-year trend of doctors moving to hospitals.
By Les Masterson • May 23, 2018 -
Right to Try bill clears House, ready for Trump's signature
The vote is the culmination of a multi-year campaign for the legislation, which aims to provide access to unapproved experimental drugs under FDA review to patients facing life-threatening illnesses.
By David Lim • May 23, 2018 -
Payers should rethink Medicare Advantage marketing, report suggests
Accenture Consulting said insurers risk millions in revenue by not taking into account how many people wait until after 65 to enroll in Medicare.
By Les Masterson • May 23, 2018 -
Trump pricing plan could lead to higher patient costs, Avalere suggests
The consultancy says a proposal to move drugs from Medicare Part B to Part D could end up costing cancer patients more out of pocket.
By Lisa LaMotta • May 23, 2018 -
Hospitals could save millions on hip, knee implants
Optimizing use of anesthesia and bone cement, along with streamlining workflow, could cut costs for the expensive procedures, a Premier report found.
By Les Masterson • May 23, 2018 -
California plan would provide Medicaid to undocumented adults
The plan could cost as much as $3 billion in 2018 and 2019.
By Les Masterson • May 22, 2018 -
CMS should extend prior authorization pilots, GAO says
The handful of Medicare prior authorization programs saved an estimated $1.1 billion to $1.9 billion through March 2017, according to a new report.
By Shannon Muchmore • May 22, 2018 -
Early 340B hospitals gave more uncompensated care than later participants
The research comes as Congress and President Donald Trump have called into question whether the program has outgrown its intent.
By David Lim • May 22, 2018 -
Georgia health system paying $4.1M to settle opioid diversion claims
The alleged drug diversion scheme at Effingham Health System spanned nearly four years and involved tens of thousands of oxycodone tablets.
By Meg Bryant • May 18, 2018 -
Payers in ACA exchanges beginning to find success
A Kaiser Family Foundation review of data from the National Association of Insurance Commissioners found that payers' MLR and gross margins have improved significantly in the ACA marketplace over the past two years.
By Les Masterson • May 18, 2018 -
Trump to nominate acting VA secretary Wilkie to lead agency
Acting Veterans Affairs Secretary Robert Wilkie will be nominated to lead the country's second-largest agency. It comes as Congress moves toward voting on a bill to expand use of private providers.
By Tony Abraham • May 18, 2018 -
Alex Wong via Getty Images
CMS weighing National Coverage Decision for CAR-T
The agency is considering whether there is enough evidence to support national Medicare coverage of the pricey cancer therapies.
By Lisa LaMotta • May 18, 2018 -
CMS to consolidate Medicare quality reporting programs
Quality Improvement Networks and Organizations, End Stage Renal Disease Networks and Hospital Improvement Innovation Networks are all being bundled into a single $25 billion contract.
By Tony Abraham • May 18, 2018 -
Interoperability a challenge for state health departments, paper says
Governance and legal challenges, such as HIPAA, pose a major barrier.
By Meg Bryant • May 18, 2018 -
Cigna, Express Scripts SEC filings reveal roadmap, backstory of $67B deal
If either terminates the merger, it may owe the other company a $1.6 billion termination fee.
By David Lim • May 17, 2018 -
Deep Dive
US health companies not quite ready for EU GDPR privacy rule
The regulation going into effect May 25 carries stiff fines for non-compliance.
By Tony Abraham • May 17, 2018 -
Azar says admin 'does not believe in' Medicare drug price negotiations
The HHS secretary reinforced a number of changes proposed in the administration's drug pricing blueprint at the American Enterprise Institute on Wednesday.
By Tony Abraham • May 16, 2018 -
CMS' Verma says no to Medicaid lifetime limits
The administrator said the agency is still closely working with states on other types of waivers.
By David Lim • May 16, 2018 -
VA finalizes rule easing virtual care delivery
The rule allows VA providers to offer telehealth services across state lines regardless of licensing and regulation requirements.
By Meg Bryant • May 15, 2018 -
Urban Institute pitches moderate plan to achieve comprehensive coverage
The proposal would keep most of the current healthcare structure in place, including employer-sponsored insurance, and could result in 16 million fewer people without insurance.
By Les Masterson • May 15, 2018 -
Vermont all-payer ACO shows early success
Meanwhile, the federal government approved Maryland's request to expand its all-payer model. Beginning in January, across-the-board rates in the state will include hospital and non-hospital settings.
By Les Masterson • May 15, 2018 -
340B scrutinized in Senate, targeted by Trump
Lawmakers questioned the program’s vague intent, lack of transparency and what they called an "inadequate" level of oversight.
By David Lim , Tony Abraham • May 15, 2018 -
Virginia weighs provider tax to fund Medicaid expansion
If approved, the state would become the 34th to expand its Medicaid program.
By Meg Bryant • May 15, 2018 -
Up to 10% with ACA coverage could jump to association health plans
Those people are more likely to be young and healthy, so their absence will leave the marketplace plans with an unstable risk pool, according to an Actuary analysis.
By Les Masterson • May 14, 2018 -
Health sector's share of US jobs hits new high
The industry is nearing full employment, according to an analysis from Altarum.
By Les Masterson • May 14, 2018
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