Government: Page 2

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    TEFCA, Health Tech Ecosystem are complementary data sharing efforts: officials

    The Health Technology Ecosystem, which the HHS and CMS launched last summer, could accelerate advancements in data exchange and isn’t in competition with the ASTP's own interoperability project, officials said.

    By • Feb. 13, 2026
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    Anna Moneymaker via Getty Images
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    HHS elevates officials into Kennedy’s inner circle in advance of midterms

    The HHS secretary has four new senior advisors to help him “move faster and go further” on his Make America Healthy Again agenda. The appointments preempt the GOP’s midterm messaging push.

    By • Feb. 13, 2026
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    Win McNamee via Getty Images
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    Lowering drug costs is on Republicans’ minds. Democrats say GOP policies don’t help.

    Lawmakers on both sides of the aisle decried the nation’s high drug costs during a House subcommittee hearing last week. Democrats argued Medicaid cuts and lapsed ACA subsidies are worsening the problem.

    By • Feb. 12, 2026
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    Kevin C. Cox via Getty Images
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    CDC moves to cut $600M in grants to Democrat-led states

    The cut grants, which were viewed by Healthcare Dive, fund a wide swath of areas including workforce initiatives, STI prevention measures, health equity proposals and others in California, Colorado, Illinois and Minnesota.

    By • Feb. 11, 2026
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    Kara Arundel/Healthcare Dive
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    House Republicans subpoena 8 health insurers over ACA fraud

    The subpoenas request additional documents and information from CVS, Centene, Elevance and more, and suggest House Republicans are considering legislation to combat what they view as rampant fraud in the ACA exchanges.

    By • Feb. 11, 2026
  • A Moderna logo is displayed on a building in Cambridge, Massachusetts, on Sept. 5, 2024.
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    Jacob Bell/Healthcare Dive
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    FDA refuses to review Moderna’s mRNA flu vaccine

    Moderna claimed that the decision, issued by top vaccine regulator Vinay Prasad, was “inconsistent” with prior FDA communications and went against the regulator’s established guidance for flu shots.

    By • Feb. 11, 2026
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    Joe Raedle via Getty Images
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    CMS proposes sweeping ACA exchange rule

    The CMS said the regulation should remove barriers to more affordable health plans like catastrophic coverage, as enrollment on the exchanges falls following the expiration of stronger financial assistance. 

    By • Feb. 10, 2026
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    Nathan Howard via Getty Images
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    White House’s online service for drug sales debuts with limited impact on prices

    Select products from Pfizer, Eli Lilly and others will be sold at a discount, although the lower costs won’t be felt by many Americans whose medications are covered by insurance.

    By Jonathan Gardner • Feb. 6, 2026
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    HHS scraps 340B rebate pilot in win for hospitals

    The Trump administration agreed to drop a controversial pilot that would have allowed drugmakers to give post-sales rebates on some drugs instead of upfront discounts.

    By • Feb. 6, 2026
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    Leigh Vogel via Getty Images
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    Express Scripts reaches ‘landmark’ settlement with FTC in insulin suit

    The agreement includes sweeping changes for Cigna’s PBM, including no longer preferring expensive drugs over cheaper equivalents on standard formularies and reshoring its controversial rebate aggregator.

    By • Updated Feb. 4, 2026
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    One-quarter of Medicaid doctors don’t actually treat Medicaid patients: study

    The new research published in Health Affairs adds to concerns about low physician participation in the safety-net insurance program, especially among mental health practitioners.

    By • Feb. 4, 2026
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    Win McNamee via Getty Images
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    Trump signs funding bill with PBM reforms, hospital-at-home and telehealth extensions

    The funding package ends a partial government shutdown and enacts several healthcare policies, including preserving telehealth flexibilities in Medicare through 2027.

    By • Feb. 4, 2026
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    Genetic testing takes greater share of Medicare Part B test spending: OIG

    Spending on the tests, which analyze genetic material from both people and pathogens, rose 20% year over year in 2024, the analysis found.

    By Susan Kelly • Feb. 4, 2026
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    Alex Wong via Getty Images
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    CMS presses ahead on accelerated Medicare Advantage audits

    The agency quietly released a memo updating MA plans on how it’s approaching risk adjustment data validation audits after a Texas judge’s ruling last year threw the expanded reviews into doubt.

    By • Feb. 4, 2026
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    Win McNamee via Getty Images
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    Telehealth flexibilities, hospital-at-home waivers lapse amid partial government shutdown

    The Senate passed a spending package Friday, but the measure is still awaiting House approval. House Speaker Mike Johnson said the partial shutdown should be brief.

    By • Feb. 2, 2026
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    CMS finalizes rule cracking down on Medicaid provider taxes

    The rule puts limits on states levying higher taxes on Medicaid businesses. The CMS argues the tax arrangements allow states to shift costs onto the federal government, but providers say they’re integral for covering the cost of care.

    By • Jan. 30, 2026
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    JHVEPhoto via Getty Images
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    Labor Department wants to strong-arm PBMs into being more transparent with employers

    The DOL proposed a rule that would force pharmacy benefit managers to share a broad range of pricing and compensation information with their employer clients, calling it the most significant proposed PBM reform in decades.

    By • Jan. 30, 2026
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    Anna Moneymaker via Getty Images
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    Medicaid contractors strike deals with CMS to help states execute work requirements

    Ten Medicaid systems vendors have agreed to provide low- or no-cost services to states over the next two years. The Trump administration said the agreements would save $600 million.

    By • Jan. 29, 2026
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    Joe Raedle via Getty Images
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    ACA enrollment backslides to 23M in 2026

    That’s down 5% from last year. But it’s not the nosedive some market watchers predicted, and a handful of states — notably, Texas — saw robust growth.

    By • Jan. 28, 2026
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    Drugs for cancer, arthritis and HIV on Medicare’s list for 2028 price cuts

    Still, the medications in the latest round of negotiations — which now includes Part B drugs given in doctor’s offices — draw very limited revenue from Medicare, an analyst pointed out.

    By Jonathan Gardner • Jan. 28, 2026
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    Deep Dive

    Health insurers brace for impact in 2026

    Profits will start to tick up after reaching trough levels. Washington will play nice. M&A and AI adoption will accelerate. We asked experts to look into their crystal balls on what the coming year means for a beleaguered industry.

    By • Jan. 28, 2026
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    Win McNamee via Getty Images
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    CMS official defends flat Medicare Advantage rate proposal for 2027

    Medicare director Chris Klomp said the Trump administration is “massively” in support of MA as health insurers cry foul over the meager rate update.

    By • Jan. 27, 2026
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    Alex Wong via Getty Images
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    CMS proposes excluding chart reviews from MA risk scoring in 2027 payment rule

    The proposal would eliminate the financial motivation insurers have to mine their members’ charts for additional diagnoses. Regulators also proposed a flat rate update for 2027, prompting anger from insurers.

    By • Jan. 27, 2026
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    Surprise Billing

    No Surprises disputes increasing even as arbiters catch up, CMS says

    The agency released new data on independent dispute resolution in the first half of 2025. Roughly 1.2 million cases were filed in that period, mostly by the same private equity-backed providers.

    By • Jan. 26, 2026
  • A brick wall with a red CVS Pharmacy sign.
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    Justin Sullivan via Getty Images
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    CVS accused of shutting out rival pharmacy hubs in House Judiciary investigation

    The company’s massive pharmacy benefit manager changed its rules and weaponized audits to ensure independent pharmacies couldn’t work with competing pharmacy service companies, House Republicans said.

    By • Jan. 26, 2026