Government: Page 2

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    Prior authorization reform: Turning regulatory pressure into a competitive edge

    PA reform: four steps that separate health plan leaders from survivors.

    By Dan Howell • Aug. 25, 2025
  • HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz confer before an event on health technology in the East Room of the White House on July 30, 2025, in Washington, DC.
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    Anna Moneymaker/Getty Images via Getty Images
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    Deep Dive

    White House data sharing plan boasts big ambitions, but has scant details

    Improving health data exchange is a worthy goal, but the initiative has to overcome challenges like data security, under-resourced providers and slow technology uptake, experts say.

    By • Aug. 21, 2025
  • Labor Explore the Trendline➔
    Trendline

    Labor

    Hospitals are navigating persistent labor shortages with the need to cut costs — a source of contention that could leave patients caught in the middle.

    By Healthcare Dive staff
  • Dr. Mehmet Oz sits on a table in front of a namecard bearing his name.
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    Anna Moneymaker/Getty Images via Getty Images
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    AdvaMed urges Dr. Oz to speed Medicare coverage of breakthrough devices

    The trade group wants the CMS to take “bold action” to cut the lag between FDA authorization of devices and Medicare coverage.

    By Nick Paul Taylor • Aug. 21, 2025
  • A view from below of the CVS sign on the center of a building, with a vertical blue HealthHub sign to its right.
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    Mario Tama via Getty Images
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    CVS Caremark fined $290M for Medicare fraud

    CVS tried and failed to convince the judge to decrease the penalty. The company plans to appeal the ruling.

    By • Aug. 20, 2025
  • A sign reading 'Elevance Health 220 Virginia Ave' in front of a large office complex on a clear day.
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    Alamy
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    Elevance loses Medicare Advantage star ratings suit

    The Texas judge’s decision — which picked apart Elevance’s argument on mathematical grounds — is expected to cost Elevance $375 million, though the insurer could still appeal.

    By • Aug. 20, 2025
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    Judge overturns rule limiting broker payments in Medicare Advantage

    Reed O’Connor’s ruling is a setback for smaller MA plans — and efforts to curb predatory marketing to seniors.

    By • Aug. 20, 2025
  • A sign for the U.S. Department of Health and Human Services stands outside a concrete building.
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    Ned Pagliarulo/Healthcare Dive
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    CMS initiative targets undocumented immigrants in Medicaid

    CMS will provide states monthly reports of beneficiaries whose citizenship or immigration status cannot be confirmed. States are expected to take “appropriate actions” including limiting coverage, the agency said.

    By • Aug. 20, 2025
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    Kennedy’s mRNA cuts could set US science back, experts warn

    Scientists say the HHS’ decision to defund mRNA vaccine research will leave the country less prepared for pandemics, and make it harder to invest in companies advancing the technology.

    By • Aug. 18, 2025
  • UnitedHealth Group office
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    Courtesy of UnitedHealth Group
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    UnitedHealth closes $3.3B Amedisys buy after long regulatory battle

    The settlement between UnitedHealth, Amedisys and the DOJ cleared the way for the deal to be finalized after a long regulatory delay. Amedisys stopped trading on Nasdaq.

    By • Aug. 15, 2025
  • Dr. Mehmet Oz arrives for his confirmation hearing with the Senate Finance Committee in the Dirksen Senate Office Building on March 14, 2025 in Washington, D.C.
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    Anna Moneymaker / Staff via Getty Images
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    Democrats question Oz on Medicare prior authorization pilot

    The CMS plans to trial prior authorization requirements in traditional Medicare. A group of Democrat representatives think that’s a bad idea based on the tool’s track record in Medicare Advantage.

    By • Aug. 13, 2025
  • A medical professional tends to a person on a stretcher.
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    Mario Tama / Staff via Getty Images
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    Hospitals prepare for $149B cut to Medicaid state-directed payments

    New limits to the program could force hospitals to slash capital spending while bracing for millions of newly uninsured patients.

    By Michael Brady • Aug. 12, 2025
  • A smiling portrait of Vinay Prasad, the director of CBER, set against a sparkling light background.
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    Retrieved from Vinay Prasad on May 08, 2025
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    Vinay Prasad, in surprise reversal, to rejoin FDA after abrupt departure

    Less than two weeks after stepping down, Prasad will return to lead CBER “at the FDA’s request,” an HHS spokesperson said. It's the latest twist in an unusual run to lead the FDA office overseeing vaccines and gene therapy.

    By Ben Fidler • Updated Aug. 11, 2025
  • UnitedHealth Group office
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    Courtesy of UnitedHealth Group
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    Deep Dive

    UnitedHealth, Amedisys merger appears set to close post-DOJ settlement

    The settlement is weaker than at least one antitrust expert expected based on the severity of the DOJ’s concerns. But it means the $3.3 billion merger is very likely to close.

    By • Aug. 8, 2025
  • Sen. Ron Wyden speaks to reporters following a regular Democratic policy luncheon on April 8, 2025. Wyden is holding up the nomination of Sean Plankey to become director of CISA.
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    Andrew Harnik via Getty Images
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    Democrat senators probe UnitedHealth over nursing home care denials

    Sens. Ron Wyden and Elizabeth Warren are seeking more information from the beleaguered healthcare behemoth after The Guardian found it was incentivizing nursing homes to reduce hospital transfers.

    By • Aug. 8, 2025
  • UnitedHealth Group office
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    Courtesy of UnitedHealth Group
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    UnitedHealth and Amedisys reach settlement with DOJ over $3.3B merger

    The settlement filed with the Maryland district court on Thursday requires UnitedHealth and Amedisys to divest 164 home health and hospice sites to placate the DOJ’s concerns that the merger is anticompetitive.

    By • Updated Aug. 7, 2025
  • The Federal Trade Commission emblem on the Constitution Center in Washington, D.C.
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    Laurel Deppen/Healthcare Dive
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    FTC moves to block Edwards’ JenaValve acquisition

    Edwards Lifesciences and JenaValve said they remained committed to completing the deal and would defend the case in court.

    By Susan Kelly • Aug. 7, 2025
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    Joe Raedle via Getty Images
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    ACA plans want to hike premiums by median of 18% next year: KFF

    The KFF’s projection is steeper than an older analysis that relied on less complete data. It’s the largest increase that ACA insurers have asked for in more than five years as payers brace for membership turmoil.

    By • Aug. 7, 2025
  • A person in a business suit speaks at a lectern with a U.S. flag in the background.
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    Rebecca Noble via Getty Images
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    HHS abandons mRNA vaccine research

    One vaccine expert called the move, which cancels some $500 million in messenger RNA research contracts, a “giant step backward for science.” 

    By • Aug. 6, 2025
  • U.S. Government Accountability Office
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    "Government Accountability Office Building" by kafka4prez is licensed under CC BY-SA 2.0
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    Trump administration illegally axed NIH grants, government watchdog says

    The Government Accountability Office can file a lawsuit in an attempt to restore the grants. However, the agency has not opted to do so during the second Trump administration.

    By • Aug. 6, 2025
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    dventtr via Getty Images
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    More urban hospitals dually classifying as rural under Medicare: study

    Dually classifying allows urban facilities to benefit from rural health programs, even as many rural facilities struggle financially and are at high risk of closure, researchers wrote.

    By • Aug. 6, 2025
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    yavdat via Getty Images
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    States sue to stop ‘unconstitutional pressure campaign’ on gender-affirming care

    A coalition of 16 states and Washington, D.C., argue the Trump administration is trying to ban gender-affirming care for minors without going through Congress.

    By • Aug. 5, 2025
  • Doctor studies financial records.
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    Trump administration finalizes health IT rule on prior authorization, electronic prescribing

    The regulation should enable workflow automation to limit paperwork burdens on providers, regulators said.

    By • Aug. 1, 2025
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    Foremniakowski via Getty Images
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    CMS finalizes inpatient payment rate increase for 2026

    Medicare finalized inpatient pay rates that are slightly higher than those proposed in April. Hospital groups were pleased with the increases, but said they were still inadequate.

    By • Aug. 1, 2025
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    Foremniakowski via Getty Images
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    Trump administration to pilot 340B rebate model next year

    The pilot is a significant departure from the current model, which gives hospitals upfront discounts for some drugs. Hospitals say 340B is a lifeline, while drugmakers say hospitals have abused the program.

    By • Aug. 1, 2025
  • A picture of Mehemet Oz sitting behind a table in a Senate hearing room.
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    Anna Moneymaker/Getty Images via Getty Images
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    Trump administration launches health data sharing initiative

    More than 60 companies, including Amazon, Google, UnitedHealth and Epic, have pledged to participate in the initiative, which the CMS said would “deliver results” early next year.

    By • July 31, 2025