Policy & Regulation: Page 2
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Medicaid waivers put transport benefits on chopping block
A new study shows non-emergency medical transportation saves Medicaid more than $40 million per month for every 30,000 beneficiaries. But some states have the longstanding benefit in their sights.
By Tony Abraham • Sept. 07, 2018
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Physician-led ACOs saw savings in Medicare program
Hospital-integrated ACOs, however, didn't have the same success, according to a study published in the New England Journal of Medicine.
By Les Masterson • Sept. 06, 2018
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JAMA studies show upsides of CMS bundled payment models
The reports found reduced institutional post-acute discharges with the CJR program and no increase in patient volume for the BPCI model.
By Les Masterson • Sept. 06, 2018
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PhRMA, hospital war over drug prices heats up
The drugmaker lobby issued a report contending hospitals upcharge meds by 500% as a hospital-led effort to develop cheaper generics took a step forward.
By Rebecca Pifer • Sept. 06, 2018
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Federal judge mulls ACA's constitutional standing
The Texas judge is reportedly "strongly considering" that the ACA is unconstitutional without its individual mandate penalty. A decision on the lawsuit could arrive any time before the end of the year.
By Tony Abraham • Sept. 05, 2018
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Gottlieb: UnitedHealth, CareFirst sign onto FDA pilot aiming to speed device coverage
The FDA chief also outlined new programs including "QUiK Review" aimed at cutting review times for well-understood, low-risk 510(k) submissions "by as much as 30%."
By David Lim • Sept. 05, 2018
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Medicare ACOs saved $1.1B in 2017, CMS data show
It comes after CMS officials predicted an overhaul of the Medicare Shared Savings Program would push ACOs to take on more financial risk in their first years of participation.
By Les Masterson • Sept. 04, 2018
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CMMI director says agency won't force all providers to assume risk
Adam Boehler said, however, that CMS wants to "create that avenue" for any practices interested in taking on more risk.
By Rebecca Pifer • Aug. 31, 2018
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Uninsured rate stays stable in 2018
Use of high-deductible health plans continued an upward trend, with nearly half of people with private insurance saying they have such coverage, new federal statistics show.
By Les Masterson • Aug. 30, 2018
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Report offers framework for assessing EHR usability, safety
The voluntary roadmap includes criteria examples for developers and providers to use in testing EHR products at each lifecycle stage.
By Meg Bryant • Aug. 29, 2018
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Hundreds of groups raise concerns about E/M payment proposal
They support efforts to cut provider administrative burden in the 2019 Physician Payment Rule but question its consolidation of office billing codes.
By Les Masterson • Aug. 29, 2018
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Health insurance tax return would increase out-of-pocket costs, report finds
Congress approved a one-year moratorium on the tax for 2019, but it is expected to return the following year.
By Les Masterson • Aug. 29, 2018
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Nixing discharges to long-term care hospitals could save Medicare $4.6B, study finds
Long-term care hospitals are reimbursed at substantially higher rates than other post-acute care arrangements.
By Meg Bryant • Aug. 28, 2018
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Deep DiveHow Scott Gottlieb is upending FDA communication, 1 tweet at a time
The FDA commissioner has been relentless in pumping out tweets, statements and more. But how has that affected FDA communications and the agency overall?
By Andrew Dunn • Aug. 28, 2018
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Critics say GOP pre-existing conditions bill flawed
The legislative effort comes as a Republican-backed court case may wipe out the ACA's protections for people with pre-existing conditions.
By Les Masterson • Aug. 28, 2018
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Next-Gen ACOs saved $62M in first reporting year, CMS says
Half of the drop in spending and utilization stemmed from just four of the 18 NGACOs active in 2016, according to a report from the agency.
By Meg Bryant • Aug. 28, 2018
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Clover Health expanding MA offerings to 6 more markets
The San Francisco-based payer also announced it is working with Taiwan-based Cathay Life Insurance to use artificial intelligence products that can predict elements like what patients will need hospitalization and when.
By Les Masterson • Aug. 27, 2018
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Medicaid expansion decreased uninsured hospitalizations for major cardiovascular events
A study of more than 3 million non-Medicare hospitalizations from databases across 30 states didn't, however, find any changes for in-hospital mortality rates in expansion or non-expansion states.
By Les Masterson • Aug. 27, 2018
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HHS asks for advice on anti-kickback rules as industry files Stark Law input
While device makers, physicians, labs and hospitals all agree changes should be made to the Stark Law to boost value-based care, the industry is split on what revisions should be made.
By David Lim • Aug. 27, 2018
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New CMS model aims to improve child behavioral health services, tackle opioid abuse
The program requires states to integrate behavioral health with primary care and preventive medicine and to use the help of community groups.
By Les Masterson • Aug. 27, 2018
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GAO highlights 3 ways HHS can improve ACA exchange membership
The new report reviewed Trump administration efforts that likely led to fewer signups during open enrollment.
By Les Masterson • Aug. 24, 2018
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HHS calls for feedback on criteria for EHR reporting program
The 21st Century Cures Act tasked HHS with developing a reporting program that assesses characteristics of EHRs including interoperability and security.
By Nick Paul Taylor • Aug. 24, 2018
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CSL expects to double flu vaccine production at North Carolina plant
Coming off one of the worst U.S. flu seasons in the past decade, the FDA has approved a new process that CSL believes will improve the way cells are grown at its Holly Springs site.
By Jacob Bell • Aug. 23, 2018
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Slavitt group, 17 health systems come together in effort to improve Medicaid
About 5% of the nation's hospitals are participating in the new project, which includes big names like Advocate Aurora, Dignity Health and Geisinger.
By Les Masterson • Aug. 23, 2018
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Questions remain about MA supplemental benefits for chronically-ill members
In a new report, the Bipartisan Policy Center said HHS and CMS will need to figure out a balance between loosening restrictions for population health programs and opening up vulnerabilities for fraud and abuse.
By Les Masterson • Aug. 22, 2018