Policy & Regulation: Page 2
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Seniors' out-of-pocket spending on cancer drugs continues to climb
Despite efforts to limit Medicare Part D beneficiaries' financial exposure to high-cost drugs, price increases have wiped out some of the expected savings.
By Samantha Liss • May 29, 2019 -
US healthcare spending estimated to grow to $3.6T this year
Fitch Solutions anticipates a 4% growth rate, below a CMS forecast from earlier this year but still driven heavily by Medicare. Private insurance is not expected to be a primary contributor to spending growth.
By Tony Abraham • May 29, 2019 -
Senate health committee takes on surprise bills, price transparency in legislative package
The American Hospital Association said it was "concerned about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers."
By Shannon Muchmore • May 24, 2019 -
Novartis gene therapy approved, but will come at cost of more than $2M
Zolgensma is designed to be a cure for spinal muscular atrophy, but its steep price will pose difficulties for a system designed for chronic therapy rather than one-time treatments.
By Ned Pagliarulo • UPDATED: May 24, 2019 at 2:03 p.m. -
CMS home-based primary care model yields mixed results
The model had some success in lowering Medicare expenditures over the four-year term but resulted in significantly higher spending, according to an outside analysis.
By Rebecca Pifer • May 24, 2019 -
AHA argues nonprofit hospitals more than make up for lost tax revenue
Tax-exempt facilities are under scrutiny, and, in some cases, caught up in litigation over their status and the perks that come with it.
By Shannon Muchmore • May 23, 2019 -
ONC advisory committee finalizes interoperability rule recommendations
The group is recommending a two-tier payment system to help health IT vendors recoup costs associated with making their systems interoperable.
By Rebecca Pifer • May 23, 2019 -
Industry groups square off on surprise billing
A Congressional hearing on the topic Tuesday came after President Donald Trump highlighted the issue earlier this month and called for a bipartisan solution that protects patients in all insurance markets.
By Shannon Muchmore • May 22, 2019 -
Show me the evidence, judge tells short-term health plan rule challengers
The government and patient advocate groups faced off in court over a final rule expanding access to short-term health insurance plans. A ruling is not expected until later this summer.
By Dana Elfin • May 22, 2019 -
More practices open to downside risk, AMGA finds
But practices listed a number of barriers to the ongoing transition to value-based payments, including lack of access to administrative claims data and physician compensation issues, according to the survey.
By Shannon Muchmore • May 22, 2019 -
Wyden introduces price transparency bill targeting payers
The legislation stipulates that commercial insurers, as well as Medicare plans, provide an online tool and toll-free phone number for members to ask about cost of services and quality of providers.
By Shannon Muchmore • May 17, 2019 -
CMS pulls back on key Part D proposals
While the final rule is seen as a win for pharmas and insurers, pharmacists and drugstores were not pleased.
By Samantha Liss • UPDATED: May 20, 2019 at 8:41 a.m. -
Small PBMs urge Congress: Don't kill rebates
An HHS rule that would eliminate Medicare and Medicaid drug rebates could have the unintended effect of raising patients' drug costs, one executive said.
By Samantha Liss • May 16, 2019 -
CMS targets PBM spread pricing
The agency is concerned the practice of charging pharmacists and health plans different prices for the same drugs is inflating costs and increasing the burden on taxpayers.
By Samantha Liss • May 16, 2019 -
Federal lawmakers put forward competing proposals to ban surprise billing, with key difference
Both bills are bipartisan, but a draft bill in the House does not include arbitration, while the Senate plan does. The American Hospital Association supports such a provision, while the payer lobby group strictly opposes it.
By Shannon Muchmore • UPDATED: May 16, 2019 at 8:47 a.m. -
FTC commissioner: M&A outpacing agency funding
The regulator and other enforcers face multiple challenges in bringing enforcement actions against hospitals, FTC Commissioner Rebecca Kelly Slaughter said.
By Dana Elfin • May 15, 2019 -
In US-China tariff poker game, health supply chains stand to lose
Tariffs on medical equipment and supplies, plus duties on imported steel and aluminum, could result in millions of increased costs for the healthcare industry and U.S. patients.
By Barry Hochfelder • May 15, 2019 -
HITAC recommends leveraging demographic data to help patient matching
The move should help correctly match patients to their healthcare records, a key problem area highlighted by interoperability experts when HHS announced its rules on the topic in February.
By Rebecca Pifer • May 14, 2019 -
Cancer patients face sticker shock under short-term plans, study finds
Short-term insurance plans are facing scrutiny from Congress and patient advocates, who argue consumers are often unaware the plans offer only bare-bones coverage.
By Dana Elfin • May 14, 2019 -
As Trump wades in, states move on surprise billing
The political climate in Washington, where even historically bipartisan efforts move slowly at best, has left states to step in and do what they can.
By Shannon Muchmore • May 14, 2019 -
FDA finalizes interchangeable biosimilar advice, with insulin focus
The agency will generally require switching studies for biologic copycats seeking a valuable interchangeable license.
By Andrew Dunn • May 14, 2019 -
Uninsurance of children, parents inched back up in 2017, report finds
Both children and parents were more likely to be uninsured in states without Medicaid expansion, according to new research from the Urban Institute.
By Meg Bryant • May 13, 2019 -
Maryland's all-payer model shows limited effects for rural hospitals
The facilities had a 9% drop in outpatient visits but no change in inpatient utilization, readmission rate or emergency department visits, according to a new study in Health Services Research.
By Shannon Muchmore • May 13, 2019 -
Insured rate dips again, to 9.4% in 2018
About 1.1 million Americans lost insurance coverage in 2018, according to CDC's annual survey. That puts the total number of uninsured in the U.S. at 30.4 million.
By Tony Abraham • May 10, 2019 -
Trump prods Congress on surprise billing ban
The president called unexpected high-cost medical bills "one of the biggest concerns Americans have about healthcare."
By Shannon Muchmore • May 09, 2019
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