Government: Page 17
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CMS allows 5 states to adopt multiyear continuous Medicaid eligibility for children
The future of such policies is unclear under an upcoming Trump administration, which could rescind approvals or prevent states from implementing waivers.
By Emily Olsen • Nov. 20, 2024 -
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RFK Jr.'s path to HHS secretaryHealthcare industry braces for RFK Jr.
Kennedy's views on vaccines in particular are causing alarm among some physicians and investors.
By Susanna Vogel • Nov. 20, 2024 -
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Trump nominates Dr. Oz to oversee Medicare, Medicaid as CMS head
On Truth Social, President-elect Donald Trump said Oz, who is best known for his eponymous TV show, would take on the “illness industrial complex.”
By Sydney Halleman • Updated Nov. 20, 2024 -
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HHS facing challenges as lead agency for healthcare cybersecurity: GAO
The department hasn’t implemented some policies recommended by the watchdog, which could pose a risk to cybersecurity in the sector as attacks increase, according to the Government Accountability Office.
By Emily Olsen • Nov. 19, 2024 -
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If enhanced ACA subsidies expire, 4M could become uninsured: report
The enhanced premium tax credits will expire at the end of next year without action from lawmakers. Republicans have previously criticized the subsidies’ cost.
By Emily Olsen • Nov. 19, 2024 -
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Eli Lilly follows J&J in suing Biden administration over 340B rebates
Major drugmakers are filing lawsuits against the HHS and HRSA to try to resuscitate plans to issue hospitals rebates instead of giving them upfront discounts on 340B drugs.
By Rebecca Pifer • Nov. 18, 2024 -
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Offering health insurance is becoming less lucrative
In the third quarter, the seven major publicly traded insurers’ medical loss ratios increased an average of 3.3 percentage points year over year — a major jump in medical costs.
By Rebecca Pifer • Nov. 18, 2024 -
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DEA, HHS issue another extension for telehealth controlled substance prescribing
The third temporary extension, which prolongs the pandemic-era flexibilities through the end of 2025, is a relief for telehealth groups who had raised concerns about access to medications.
By Emily Olsen • Nov. 18, 2024 -
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RFK Jr.'s path to HHS secretary
Trump nominates RFK Jr. to lead HHS
The nomination of a prominent vaccine skeptic to the head of the nation’s largest healthcare program is expected to alarm some public health experts.
By Sydney Halleman • Nov. 14, 2024 -
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Top CMS official urges Trump administration to treat Medicaid with care
“Do to others what you would want done to yourself,” Medicaid director Daniel Tsai said Thursday when asked about advice for his replacement in Trump’s HHS. Trump is expected to cut Medicaid eligibility and funding.
By Rebecca Pifer • Nov. 14, 2024 -
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CMS to lower importance of ‘call center’ metric in Medicare Advantage star ratings
Regulators’ assessment of customer support centers has spurred recent lawsuits from insurers. But the metric “is going to have a smaller weighting on star ratings moving forward,” the director of Medicare said.
By Rebecca Pifer • Updated Nov. 15, 2024 -
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Tenet CEO looks ahead to second Trump term
Saum Sutaria doesn't think the ACA marketplace is going anywhere under President-elect Donald Trump, noting beneficiaries are an “important part of the electorate” for the incoming administration.
By Susanna Vogel • Nov. 13, 2024 -
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J&J sues federal government for halting 340B rebate plan
The New Jersey-based drugmaker is trying to get the courts’ backing to pay hospitals rebates for two drugs in the 340B drug discount program, instead of offering upfront discounts.
By Rebecca Pifer • Nov. 13, 2024 -
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DOJ sues to block UnitedHealth’s $3.3B buy of home health firm Amedisys
The DOJ’s complaint is intentionally broad to maximize its chances of success, according to one expert. Still, the incoming Trump administration could throw cold water on the challenge.
By Rebecca Pifer • Nov. 12, 2024 -
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Many hospitals still aren’t complying with price transparency rule: OIG
In a sample of 100 hospitals, 34 didn’t meet requirements for publishing machine-readable files of their charges while 14 didn’t follow rules to post shoppable services.
By Emily Olsen • Nov. 12, 2024 -
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MedPAC backs tying physician pay to inflation, but ducks specifics
During a meeting Thursday, commissioners debated different solutions to lackluster physician pay with one theme in common: linking doctors’ annual payment update to the Medicare Economic Index.
By Rebecca Pifer • Nov. 8, 2024 -
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HHS settles 2 ransomware investigations as attacks rise
The settlements mark the sixth and seventh healthcare ransomware enforcement actions from regulators.
By Emily Olsen • Nov. 7, 2024 -
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How the healthcare industry is reacting to a second Trump term
Donald Trump’s first term as president was characterized by significant turbulence for government healthcare programs. Here’s how some of the most influential industry groups responded to the Republican’s reelection.
By Rebecca Pifer • Nov. 7, 2024 -
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MACPAC calls for greater transparency amid steep rise in Medicaid directed payments
Dramatic growth in an opaque Medicaid funding mechanism is exacerbating concerns about the program’s fiscal integrity — while spurring financial gains for the hospital industry.
By Rebecca Pifer • Nov. 5, 2024 -
Photo illustration: Industry Dive; Joe Readle/Getty Images; Brandon Bell/Getty Images
As presidential election looms, disparate approaches to cyber policy come into focus
Government officials and security leaders are hoping the nation’s need for cyber resilience will transcend partisan politics regardless of the election results.
By David Jones • Nov. 5, 2024 -
Elise Reuter/Healthcare Dive
Michelle Tarver faces challenges as new CDRH leader. But patient groups, industry are optimistic.
Tarver is taking over as director of the Center for Devices and Radiological Health as the regulator grapples with questions around artificial intelligence in medical devices and racial bias in pulse oximeters.
By Elise Reuter • Nov. 4, 2024 -
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Elevance Health sues HHS over Medicare Advantage star ratings
The payer joins several other insurers suing federal regulators over the 2025 quality ratings, which Elevance argues will cost it at least $375 million in bonus payments and rebates.
By Emily Olsen • Nov. 4, 2024 -
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Physicians, hospitals decry 2025 Medicare payment rates
Physicians will see their Medicare reimbursement fall 2.9% next year if Congress doesn’t stop the cuts. Meanwhile, reimbursement for hospital outpatient departments is rising 2.9%.
By Rebecca Pifer • Nov. 4, 2024 -
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Medicare saves record $2.1B from largest accountable care program
Citrus ACO in Central West Florida had the highest savings rate, while Health Connect Partners — an ACO operated by hospital giant Providence — had the highest total savings in the Medicare Shared Savings Program last year.
By Rebecca Pifer • Oct. 31, 2024 -
Retrieved from Crozer Health.
Pennsylvania attorney general sues Prospect Medical alleging ‘corporate greed’
The lawsuit argues Prospect broke the terms of its agreement to purchase Pennsylvania system Crozer Health and seeks to stop the hospital operator from closing more facilities.
By Susanna Vogel • Oct. 31, 2024
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