CMS finalizes 2024 Medicare hospital, doctor payments, 340B fix and price transparency requirements

Regulators finalized a number of rules Thursday with sweeping implications for providers in the Medicare program, including rates for next year that doctors and hospitals slammed as insufficient.

By Rebecca Pifer • Nov. 3, 2023

AHA, hospitals sue Biden administration to stop restrictions on website tracking tech

The lawsuit filed on Thursday alleges the agency overstepped when issuing guidance seeking to limit hospitals’ use of third-party tracking technologies.

By Susanna Vogel • Nov. 3, 2023

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Surprise Billing

Federal legislation banning surprise bills has hit a barrage of roadblocks, complicating efforts to protect consumers from unexpected out-of-network charges.

By Healthcare Dive staff

North Carolina AG threatens lawsuit against HCA

The massive for-profit operator has allegedly shuttered services at Mission Health, the hospital system it acquired in 2019, violating the terms of its purchase agreement.

By Susanna Vogel • Nov. 2, 2023

White House orders HHS to collect reports on healthcare AI safety

President Joe Biden outlined the planned program as part of an executive order on “safe, secure, and trustworthy” artificial intelligence.

By Nick Paul Taylor • Nov. 1, 2023

HHS announces first ransomware settlement

Doctors’ Management Services agreed to settle claims it did not comply with HIPAA breach rules and failed to identify risks after a cyberattack exposed the information of more than 200,000 patients.

By Susanna Vogel • Nov. 1, 2023

Tracking healthcare data breaches

A breach at a New York-based imaging center may have exposed the personal information of more than 600,000 people.

By Emily Olsen , Susanna Vogel • Updated Dec. 5, 2023

Biden administration overhauls surprise billing resolution process amid controversy

Regulators proposed a rule on Friday meant to make payment dispute resolutions more fair and efficient following more than a year of industry complaints.

By Rebecca Pifer • Oct. 30, 2023

Guidance change threatens hospital 340B drug discounts

The Health Resources and Services Administration is once again requiring hospitals to register outpatient clinics and list them on Medicare cost reports, setting a higher bar for eligibility in the drug discount program.

By Rebecca Pifer • Oct. 27, 2023

Defunct direct contracting model saved Medicare $372M last year

Value-based primary care chains for seniors operated by major retail health players did particularly well, with Amazon’s Iora, CVS’ Oak Street and Walgreens’ VillageMD all notching high net savings.

By Rebecca Pifer • Oct. 25, 2023

Calling healthcare burnout a crisis is an ‘understatement,’ CDC says

The Centers for Disease Control and Prevention is sounding the alarm on increasing levels of burnout and harassment in the healthcare industry.

By Susanna Vogel • Oct. 25, 2023

Prospect Medical Holdings clear to seek buyer for Crozer Health

The private equity firm has nine months to find a buyer for its struggling four-hospital health system under an agreement announced by the Pennsylvania attorney general last week.

By Susanna Vogel • Oct. 24, 2023

2.3M people would gain coverage if 10 remaining states expanded Medicaid, report finds

Black people, young adults and women, especially those of reproductive age, would see the biggest coverage gains, according to the Robert Wood Johnson Foundation and the Urban Institute.

By Emily Olsen • Oct. 24, 2023

Amwell, Leidos score defense contract worth up to $180M

Analysts predict the contract could be worth up to $54 million for Amwell alone over its 22-month term.

By Emily Olsen • Oct. 20, 2023

Senators urge CMS to withhold staffing mandate, citing negative impact on veteran care

Members of the Senate Veterans Affairs Committee urged the CMS to rescind or revise its staffing proposal for nursing facilities on Thursday, warning the rules could cause facilities to close.

By Susanna Vogel • Oct. 19, 2023

FDA prioritizes guidance on AI, cybersecurity, pulse oximeters in stacked schedule for 2024

The administration is ramping up production of medtech guidance, adding 18 draft documents to the list of priorities for the upcoming financial year.

By Nick Paul Taylor • Oct. 19, 2023

California sets $25 per hour minimum wage for healthcare workers

The law, backed by healthcare unions, is expected to affect approximately 469,000 healthcare workers and will be phased in over the next several years.

By Susanna Vogel • Oct. 16, 2023

Share of MA, Part D plans earning top star ratings drops in 2024

About 42% of Medicare Advantage plans that offer prescription drug coverage in 2024 earned four or more stars, compared with just over half this year. 

By Emily Olsen • Oct. 13, 2023

Sanders criticizes nonprofit hospitals for not providing enough charity care

The report from the Chair of the Senate HELP Committee calls for more federal oversight into nonprofit hospitals' charity care, accusing the systems of providing "paltry amounts" of charity care

By Sydney Halleman • Oct. 12, 2023

DEA temporarily extends telehealth prescribing rules for controlled substances again

The Drug Enforcement Administration and the HHS announced they would extend pandemic-era flexibilities for prescribing controlled substances virtually through the end of 2024.

By Emily Olsen • Oct. 9, 2023

Aetna may have received $25.5M in MA overpayments for 2015 and 2016, audit finds

Medical records provided by the insurer didn’t support certain diagnosis codes, resulting in overpayments, according to an audit from the HHS Office of the Inspector General.

By Emily Olsen • Oct. 6, 2023

Warren, Jayapal call for closer scrutiny of UnitedHealth-Amedisys deal

The progressive lawmakers sent a letter Tuesday to top antitrust regulators urging heightened attention to the $3.3 billion transaction, which is currently under investigation by the Department of Justice.

By Rebecca Pifer • Oct. 4, 2023

AHA urges lawmakers to roll back online tracking tech restrictions

The hospital lobby argued recent guidance limiting third-party tracking technology prevents providers from sharing reliable healthcare information.

By Emily Olsen • Oct. 2, 2023

Cigna pays $172M to settle MA upcoding allegations

The agreement settles a whistleblower lawsuit against Cigna that the Department of Justice joined last year, and requires the payer to undergo annual auditing from an independent entity.

By Rebecca Pifer • Oct. 2, 2023

CMMI increased federal spending by $5.4B during its first decade, report finds

The Congressional Budget Office report estimated the Center for Medicare and Medicaid Innovation, which was created in part to reduce spending, will increase net federal spending by $1.3 billion from 2021 through 2030.

By Emily Olsen • Sept. 29, 2023

Congressional Democrats open investigation into Medicaid MCOs over claims denials

Sen. Ron Wyden, D-Ore., and Rep. Frank Pallone, D-N.J., sent letters requesting information on coverage denials to seven payers, including UnitedHealthcare, Aetna and Centene.

By Rebecca Pifer • Sept. 29, 2023