Government: Page 150
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Deep Dive
Don't let the name fool you, ACA 'skinny' repeal has major consequences
A scaled-down version of ACA repeal is the latest GOP healthcare proposal, but it may just be a vehicle for returning to earlier, more conservative legislation.
By Shannon Muchmore • July 27, 2017 -
Failed BCRA vote shows tough road ahead for ACA repeal, replace
A procedural vote to continue discussion of Republican healthcare legislation passed on Tuesday afternoon.
By Shannon Muchmore • July 25, 2017 -
Appalachian health systems seek merger that avoids FTC oversight
The two health systems are using a legal avenue called a Certificate of Public Agreement in an attempt to sidestep federal review.
By Les Masterson • July 24, 2017 -
Parliamentarian review makes passing BCRA even harder
Provisions that cannot be passed through the budget reconciliation process include removing essential health benefits for state Medicaid plans and the defunding of Planned Parenthood.
By Shannon Muchmore • July 24, 2017 -
CMS wants more oversight over Medicare Advantage provider networks
The CMS found in January that 45% of MA provider directories had incorrect information.
By Les Masterson • July 21, 2017 -
CBO: Out-of-pocket health costs would skyrocket under revised BCRA
The newest CBO score doesn't change much of the political discussion currently, but it has some drastic illustrations of how high deductibles and general out-of-pocket spending could get.
By Shannon Muchmore • July 21, 2017 -
Payers see growth opportunities in Medicare Advantage
Humana plans to add 500 employees to handle MA applications during the open enrollment period.
By Les Masterson • July 20, 2017 -
CBO: ACA repeal would cause 32M to lose insurance by 2026
The latest analysis found average premiums in the nongroup market would increase by about 25% next year and nearly double by 2026.
By Shannon Muchmore • July 20, 2017 -
Deep Dive
The BCRA is dead, but don't take your eye off Capitol Hill
The healthcare industry may have dodged a bullet, but this week’s legislative stumbles for the GOP don’t mean healthcare is off the table for Congress. Here's what to watch.
By Shannon Muchmore • July 18, 2017 -
Reducing hospital readmissions not associated with increased risk of death, study finds
The study looks at unintended consequences of CMS’ Hospital Readmissions Reduction Program.
By Meg Bryant • July 18, 2017 -
Deep Dive
Federal fraud takedown another warning shot for providers
Last week, the HHS charged 412 individuals for a total of $1.3 billion in false healthcare billings, the largest enforcement action from the agency yet.
By Jeff Byers , Shannon Muchmore • July 18, 2017 -
UPDATE: BCRA, repeal-and-delay plans both dead for now
The GOP won’t easily give up its best chance to repeal the ACA since the law was enacted, but options are dwindling.
By Shannon Muchmore • July 18, 2017 -
Lawmakers prod CMS to collect Meaningful Use overpayments
A recent HHS Inspector General’s investigation found CMS paid more than $700 million to healthcare professionals who did not meet the program's requirements.
By Meg Bryant • July 18, 2017 -
Politico: Nonprofit hospitals cut back community spending despite revenue increases
The top seven hospitals had a combined revenue increase of 15% over two years after the ACA’s coverage expansions, but their charity care spending went down 35%.
By Shannon Muchmore • July 17, 2017 -
Deep Dive
Despite federal delays, bundled payments will be entrenched in US healthcare
Bundled payment models serve as an entry to value-based care because of the relatively low risk providers take on. While these programs aren't yet proven to be successful, there is enough positive data to support participation.
By Les Masterson • July 17, 2017 -
UnitedHealth requests federal court dismiss Medicare Advantage lawsuit
The payer is involved in two whistleblower lawsuits involving alleged MA overpayments.
By Les Masterson • July 17, 2017 -
Report: US healthcare system worst among 11 wealthy nations
The Commonwealth Fund study found the U.S. has the highest healthcare costs and lowest overall performance for all the nations studied.
By Les Masterson • July 15, 2017 -
CMS proposes big 340B drug payment cuts, outpatient rate changes
The agency is also requesting ideas on regulatory and policy changes to advance flexibility, administrative simplification and innovation.
By Jeff Byers , Shannon Muchmore • July 13, 2017 -
Senate Republicans' new draft of healthcare bill makes few changes
The revised draft includes an amendment that would allow insurers to sell plans that do not meet minimum ACA requirements so long as they offer at least one plan that does. The insurance industry has opposed this idea.
By Shannon Muchmore • July 13, 2017 -
Major barriers remain to value-based implementation, survey finds
Smaller organizations were least likely to report using value-based reimbursement initiatives in a recent EY Health survey.
By Shannon Muchmore • July 13, 2017 -
HHS reports 'largest healthcare fraud takedown in history'
This month more than 100 medical professionals were among those charged in false billing schemes involving more than $1.3 billion.
By Les Masterson • July 12, 2017 -
Anthem Blue Cross expands program that denies claims for unnecessary ED services
The American College of Emergency Physicians and its Missouri chapter said rejecting ED claims is a “clear violation of the national prudent layperson standard.”
By Les Masterson • July 12, 2017 -
Report: Cutting essential health benefits won't save much money
Republicans on Capitol Hill have raised the idea of cutting EHB requirements as they seek to replace the Affordable Care Act.
By Les Masterson • July 11, 2017 -
Medicaid beneficiaries report high satisfaction, access to care
The survey comes as the program faces a potential restructuring, including massive funding cuts and an end to expansion.
By Shannon Muchmore • July 11, 2017 -
Individual insurance market shows signs of stabilizing, report finds
A new Kaiser Family Foundation report found improved medical loss ratios and payer margins in the first quarter of 2017, but also rising premiums. CMS on Monday announced fewer payers have signed up for ACA exchanges for 2018.
By Les Masterson • July 10, 2017
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