Policy & Regulation: Page 2

Aetna to pay $1M to settle 3 patient data HIPAA breaches

The potential violations all occurred over a six-month period in 2017 and affected a total of more than 18,000 members, the HHS Office for Civil Rights said. The payer is not admiting liability.

By Shannon Muchmore • Oct. 29, 2020

Second interoperability deadline extension likely final delay, ONC chief says

Some health IT experts have criticized the delays, arguing that free and unfettered data sharing could help the country coordinate its pandemic response as the U.S experiences a third spike in COVID-19 cases.

By Rebecca Pifer • Oct. 29, 2020

Explore the Trendline➔

Trendline

Social determinants of health

The focus on social determinants of health has only increased as the COVID-19 pandemic has devastated the United States.

By Healthcare Dive staff

Trump admin pushes back interoperability deadline for second time

The move was expected — rumors swirled for weeks amid public comments from top health IT officials and a proposed rule with a title hinting at deadline extension — but is a significant increase in the timeline for compliance.

By Rebecca Pifer • Oct. 29, 2020

CMS requires government, most private plans to cover COVID-19 vaccines

Commercial payers are likely already modeling costs. Anthem CEO Gail Boudreaux said Wednesday the insurer considered multiple variables when determining pricing and will follow CMS guidance.

By Shannon Muchmore • UPDATED: Oct. 29, 2020 at 12:47 p.m.

Final rule requires health plans to make negotiated rates public

CMS Administrator Seema Verma fought back against claims the regulation will stifle competition. "Don't be fooled ... such complaints are all about protecting a considerable profit special interest reaped from business as usual," she said.

By Shannon Muchmore • Oct. 29, 2020

Gilead's Veklury becomes first FDA-approved drug for treating COVID-19

The U.S. regulator granted a full approval after allowing emergency use earlier this year. New results from a WHO study, however, raise questions about the drug's ultimate effectiveness.

By Ben Fidler • UPDATED: Oct. 23, 2020 at 10:05 a.m.

4 healthcare storylines overshadowed by COVID-19

The magnitude of the crisis has all but stopped some efforts, like a ban on surprise billing. But other policies are forging ahead, including price transparency requirements for hospitals beginning Jan 1.

By Shannon Muchmore • Oct. 22, 2020

HHS walks back CARES fund reporting requirement hospitals feared

The department said it had earlier concerns that some providers would wind up more profitable than they were before the COVID-19 pandemic.

By Samantha Liss • UPDATED: Oct. 23, 2020 at 10:07 a.m.

From back-to-work to telehealth to retail rebranding: HLTH 2020 takeaways

Trump administration officials also provided an update on value-based care models, teased details of the coronavirus vaccine's approval and hinted at a coming reimbursement plan.

COVID-19 has sparked more concerns about healthcare costs, insurance, TransUnion says

More people, especially those in younger generations, are using insurer websites to conduct cost research, the annual survey found.

By Ron Shinkman • Oct. 21, 2020

CMS approves controversial Medicaid waiver in Nebraska, creating 2-tiered system

The expansion is a more creative way to implement work or job training requirements, but opponents argue it will deprive some enrollees of benefits.

By Samantha Liss • Oct. 21, 2020

Providers' rocky road to recovery could last into 2022

About 20% of hospital executives told Kaufman Hall they were "extremely concerned" about their financial viability, as the Midwest reports rising COVID-19 caseloads and providers prep for the pandemic to collide with flu season.

By Shannon Muchmore • Oct. 20, 2020

ACA plan premiums to fall 2% in 2021, CMS says

The price easing comes despite the Trump administration's efforts to chip away at the law, including support for the case to overturn it now before the Supreme Court. But affordability remains a challenge for some who don't get subsidies.

By Rebecca Pifer • Oct. 20, 2020

CVS wants pharmacy techs to administer COVID-19 vaccine, plans to hire 10,000 more

This week the Trump administration released guidance authorizing pharmacy technicians and pharmacy interns to administer coronavirus vaccines and COVID-19 diagnostic tests.

By Rebecca Pifer • UPDATED: Oct. 23, 2020 at 9:25 a.m.

Deep Dive

Retail's role, focus on equity, value-based pay amid COVID-19: takeaways from HLTH 2020

Back-to-work products, coronavirus vaccine distribution and telehealth ROI were also hot topics at the conference's third year.

By Rebecca Pifer • Oct. 19, 2020

CMS to cut COVID-19 test pay by 25% for delayed results, labs cry foul

The American Clinical Laboratory Association, which includes LabCorp and Quest, argued the new policy fails to address the root of delays: fluctuating demand and supply chain disruptions.

By Nick Paul Taylor • Oct. 19, 2020

The hazy post-pandemic future of telehealth

"The effective application of technology and data to healthcare is the foundation for efficient healthcare, but has so far failed to deliver on its potential," the managing partner of Blue Ox Healthcare Partners said Thursday.

By Rebecca Pifer • Oct. 16, 2020

Elective surgeries seen coming back in Q3, but can it last?

Analysts forecast a recovery in procedures in the third quarter as patients rescheduled, but some now see a leveling off in hospital activity. The flu season also poses a risk going into the winter.

By Susan Kelly • Oct. 15, 2020

CMS expands Medicare emergency telehealth coverage with 11 new services

The agency also said more than 36% of those in traditional Medicare used a virtual visit between March and August and usage among Medicaid members has skyrocketed.

By Rebecca Pifer • Oct. 15, 2020

Payer competition shrinks in already scarce markets, AMA survey finds

The five insurers with the biggest share in the most markets were Anthem, Health Care Service Corp., UnitedHealth Group, Florida Blue and Highmark.

By Hailey Mensik • UPDATED: Oct. 15, 2020 at 10:02 a.m.

Hospitals warn of 'devastating' impact from CARES funds reporting change

The problem centers on how the agency is now defining "lost revenue." AHA bashed the change as "simply unfair and unrealistic" and added it would create an "administrative and accounting disaster."

By Samantha Liss • Oct. 14, 2020

Medicare coronavirus vaccine pay rule predicted by month's end, Verma says: HLTH 2020

It's unclear whether CMS has the regulatory power to reimburse for a vaccine if approved by the FDA under an emergency use authorization, as public health officials expect. The rule will likely tackle that.

By Rebecca Pifer • Oct. 13, 2020

HHS says hospitals must now report flu data as well as COVID-19 numbers

Facilities will have 14 weeks to comply with the requirement that will inform distribution of treatment and supplies as public health officials worry about a dangerous clash of flu season and the pandemic.

By Hailey Mensik • Oct. 07, 2020

More than 14M may have lost health coverage after historic job losses, study finds

Not all lost jobs result in a loss of coverage, so researchers have been keen to figure out how historic unemployment has ultimately affected insurance status.

By Samantha Liss • Oct. 07, 2020

Citing COVID-19, providers push back on CMS payment rule rate cuts, telehealth rollback in 2021

The AMA and AHA are among those lobbying hard against any payment reduction amid the pandemic. Stakeholders also spoke out against rolling back coverage of audio-only virtual visits and nixing the inpatient-only list.

By Hailey Mensik • Oct. 06, 2020