Government: Page 19
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Democrats introduce bill to make increased ACA subsidies permanent
If the enhanced tax credits expire, healthcare costs for millions of Americans will suddenly increase, and some could become uninsured, Democrats say. But Republicans argue the subsidies are costly and create opportunities for fraud.
By Rebecca Pifer , Emily Olsen • Sept. 26, 2024 -
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Tracking Steward's declineSenate votes unanimously to hold Steward Health Care CEO in criminal contempt
It’s the first time in more than 50 years the Senate has voted to send a contempt charge to the U.S. Department of Justice, which will determine whether to bring charges against Ralph de la Torre.
By Susanna Vogel • Updated Sept. 26, 2024 -
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Home care agency settles allegations it accommodated ‘race-based requests’ for aides
The home health aide provider allegedly terminated the assignments of Black and Hispanic aides to accommodate patients’ and family members’ racial preferences, the Equal Employment Opportunity Commission said.
By Ginger Christ • Sept. 25, 2024 -
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Remote patient monitoring in Medicare needs more oversight: OIG
Regulators say Medicare needs more data and oversight to avoid fraud and misuse. Digital health advocates argue the service is still crucial for managing chronic conditions.
By Emily Olsen • Sept. 25, 2024 -
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HHS to invest nearly $75M in rural healthcare
The funds will go toward expanding substance use disorder treatment and maternal healthcare services, as well as helping rural hospitals keep their doors open.
By Emily Olsen • Sept. 25, 2024 -
Courtesy of Food and Drug Administration
CMS holds accountable care organizations harmless for ‘highly suspect’ Medicare billing
Aberrant billing for urinary catheters last year could have made it harder for ACOs in Medicare to bring in shared savings. That’s no longer the case under a new final rule.
By Rebecca Pifer • Sept. 25, 2024 -
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Novo CEO pressed by Senate to cut prices of obesity, diabetes drugs
CEO Lars Fruergaard Jørgensen told lawmakers the company would consider new talks with insurers about the list prices of Wegovy and Ozempic if they pledge to keep the medicines on their formularies.
By Jonathan Gardner • Sept. 25, 2024 -
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Overturning of Roe v. WadeTop Senate Democrat grills hospitals on EMTALA compliance as women denied emergency abortions
Sen. Ron Wyden, D-Ore., sent letters to eight hospitals that have reportedly refused patients emergency abortion care in potential violation of federal law.
By Rebecca Pifer • Sept. 24, 2024 -
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Texas attorney general, generative AI company settle over accuracy allegations
The agreement resolves allegations that Pieces Technologies made deceptive claims about the accuracy of its documentation products. Pieces denied any wrongdoing.
By Emily Olsen • Sept. 23, 2024 -
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OpinionTelehealth providers at a crossroads: Navigating insurance, compliance and cash-only models amid state regulations
Providers using telehealth face an evolving landscape, and they must balance complexities around insurance, regulatory compliance and data privacy, argues one legal expert.
By Paul Schmeltzer • Sept. 20, 2024 -
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FTC sues major pharmacy benefit managers over insulin prices
The agency brought action against Caremark, Express Scripts and Optum Rx, arguing their “anticompetitive and unfair” rebating practices “artificially inflated” the list price of life-saving insulin drugs.
By Rebecca Pifer • Updated Sept. 20, 2024 -
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House committee passes telehealth flexibility extension
The bill would extend pandemic-era telehealth flexibilities in Medicare for another two years, averting a looming year-end deadline.
By Emily Olsen • Sept. 20, 2024 -
Susanna Vogel/Healthcare Dive, data from Susanna Vogel
Tracking Steward's declineSenate committee unanimously votes to hold Steward CEO in contempt
“If you defy a congressional subpoena, you will be held accountable — no matter who you are or how well connected you may be,” said Sen. Bernie Sanders during the hearing.
By Susanna Vogel • Sept. 19, 2024 -
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Oak Street Health pays $60M to settle allegations of kickback scheme
Before the primary care chain was purchased by CVS Health, Oak Street illegally paid marketing agents for referring Medicare-eligible seniors to its clinics, according to the Department of Justice.
By Rebecca Pifer • Sept. 19, 2024 -
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US is drastically behind other wealthy nations on healthcare, despite spending the most
The Commonwealth Fund analyzed the healthcare systems of 10 nations and found the U.S. ranked last in access to care, health outcomes and overall. The U.S. “really is in a class by itself,” one researcher said.
By Rebecca Pifer • Sept. 18, 2024 -
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J&J threatened with sanctions over plan to rebate 340B drugs
The HHS agency that oversees the 340B drug discount program is threatening Johnson & Johnson with steep fines — and loss of access to Medicare and Medicaid — if it stops giving hospitals upfront discounts.
By Rebecca Pifer • Sept. 18, 2024 -
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Express Scripts sues FTC over report damning pharmacy benefit managers
The major PBM said its lawsuit is necessary to protect against misinformation about the controversial drug middlemen, while the FTC promised to defend its research.
By Rebecca Pifer • Sept. 17, 2024 -
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Walgreens settles allegations of fraudulent billing with DOJ
The Illinois-based pharmacy giant has agreed to pay almost $107 million to settle claims it billed Medicare, Medicaid and other government programs for prescriptions that were never dispensed.
By Rebecca Pifer • Sept. 16, 2024 -
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Medicare Advantage bonuses poised to drop this year for first time since 2015, KFF says
Still, plans are expected to rake in $11.8 billion in bonuses, with half of that tranche going to just two insurers: UnitedHealthcare and Humana.
By Rebecca Pifer • Sept. 13, 2024 -
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OpinionCalifornia’s data exchange framework proves government can do big things
The secretary of California HHS argues the state’s new data exchange improves health equity and streamlines information.
By Mark Ghaly • Sept. 12, 2024 -
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PBM executives decline to revise controversial testimony to House committee
The leaders of Caremark, Optum Rx and Express Scripts had until last week to walk back statements they made in July — or face potential legal action. However, the executives are sticking to their guns.
By Rebecca Pifer • Sept. 12, 2024 -
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Telehealth groups urge Congress, White House to extend controlled substance virtual prescribing
More than 300 telehealth and provider organizations say time is running out for regulators to propose a rule before pandemic-era flexibilities expire at the end of the year.
By Emily Olsen • Sept. 11, 2024 -
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Iowa awards Centene Medicaid managed care contract
Iowa Total Care, a subsidiary of the St. Louis-based payer, can continue doing business in Iowa’s managed care program, which paid it $2.8 billion in the last fiscal year.
By Rebecca Pifer • Sept. 10, 2024 -
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Biden administration finalizes rule raising mental health coverage standards for private plans
The rule gives additional teeth to an almost 16-year-old law meant to force health insurers to cover mental health and substance use benefits at the same level as physical healthcare.
By Rebecca Pifer • Sept. 10, 2024 -
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CMS says data breach at contractor could affect more than 946,000 Medicare beneficiaries
The incident was related to a vulnerability in the MOVEit file transfer software, which was linked to data breaches at thousands of organizations last year.
By Emily Olsen • Sept. 9, 2024
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