Policy & Regulation: Page 2
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Permission granted by Biogen
Congress pressures FDA, Biogen on Alzheimer's drug approval, price
The agency's decision-making process as well as Biogen's pricing of Aduhelm at $56,000 per year are both under the microscope as the repercussions of the controversial OK continue to be felt.
By Jonathan Gardner • June 29, 2021 -
SCOTUS will not hear hospitals' appeal against site-neutral payments
The rule barring hospitals from receiving higher reimbursements for outpatient services compared to other providers was widely challenged, but now stands with the high court's decision.
By Hailey Mensik • June 29, 2021 -
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While labor strife among healthcare workers is hardly new, the COVID-19 pandemic brought new issues to the table, including re-use of personal protective equipment and other safety measures.
By Healthcare Dive staff -
Biden administration aims to further rebuild ACA with proposed rule
The regulation would lengthen the annual open enrollment period, expand the role of navigators and nix Trump-era guidelines for waivers that were criticized for allowing states to skirt coverage requirements.
By Shannon Muchmore • June 29, 2021 -
Permission granted by E.A. Crunden
Lawmakers reintroduce diagnostic regulation bill that split industry
The VALID Act would create a risk-based regulatory framework for in vitro diagnostics and laboratory-developed tests. ACLA, whose members include Quest and LabCorp, is reviewing the bill but has objected to earlier drafts.
By Nick Paul Taylor • June 28, 2021 -
Go Nakamura via Getty Images
CMS does not have enough authority to ensure hospital safety during pandemics, OIG says
The watchdog recommended CMS develop regulations that allow it to require special surveys during public health emergencies and after issuing substantive new guidance. The agency agreed with the recommendation.
By Shannon Muchmore • June 28, 2021 -
Gabriel Kuchta via Getty Images
More hospitals poised to require COVID-19 vaccines
It's "a trickle that will become a torrent," Ashish Jha, dean at Brown University's School of Public Health, tweeted.
By Samantha Liss • June 28, 2021 -
Sean M. Haffey via Getty Images
San Diego sues Molina, Kaiser, Centene's HealthNet over alleged 'ghost networks'
Ghost networks, provider directories that list out-of-network physicians as in-network, cause consumers to think their coverage is more comprehensive than it actually is and can make access to care even more difficult.
By Rebecca Pifer • June 28, 2021 -
Half of ambulance rides could result in surprise bill, KFF finds
A ban on surprise billing kicks into effect next year, but ambulances are exempt from the legislation, meaning patients will still be on the hook for those pricey, unexpected bills.
By Rebecca Pifer • June 25, 2021 -
Retrieved from C-SPAN on February 23, 2021
Biden admin 'absolutely supportive' of telehealth once crisis ebbs, Becerra says
The HHS secretary also stressed that, though affordable virtual care should be available to all, the agency would double down to ensure accountability for quality of care.
By Rebecca Pifer • June 24, 2021 -
Missouri judge blocks voter-approved Medicaid expansion
Despite of the win at the ballot box in 2020, the state legislature failed to make funds available to expand the program to about 230,000 low-income adults.
By Samantha Liss • June 24, 2021 -
Sarah Silbiger via Getty Images
FDA documents show how controversial Alzheimer's drug decision was reached
A group of statisticians who had argued for rejection were overruled, internal memos show, as high-ranking agency officials got behind an accelerated clearance for Biogen's drug.
By Jacob Bell , Ned Pagliarulo • June 23, 2021 -
Alex Wong via Getty Images
CMS releases $20M in grants to bolster state-based marketplaces
States with their own eligibility platforms have enrolled more than 3.8 million people in ACA plans so far for the 2021 plan year. Many are now eligible for lower out-of-pocket costs or reduced monthly premiums.
By Rebecca Pifer • June 23, 2021 -
Getty / edited by Healthcare Dive
LifePoint to acquire Kindred, adding long-term and rehab facilities to its footprint
The private-equity backed companies did not disclose terms, but jointly took in about $14 billion in combined revenue in 2017, the last year of publicly disclosed information about their operations.
By Ron Shinkman • June 22, 2021 -
Justin Sullivan via Getty Images
New York passes safe staffing law for hospitals, nursing homes
"This law doesn't state that ratios must be stipulated, but inevitably that's what it means," said Judy Sheridan-Gonzales, president of the New York State Nurses Association.
By Hailey Mensik • June 22, 2021 -
Courtesy of Siemens Healthineers
UnitedHealthcare skimping on COVID-19 test pay, California doctor group alleges
The California Medical Association says UnitedHealthcare still is not covering the cost of all COVID-19 diagnostic testing, despite state and federal guidelines that require the services to be provided at no cost to patients.
By Susan Kelly • June 22, 2021 -
Adobe Stock
Record 1 in 4 Americans now covered by Medicaid, CHIP
Nearly 10 million people enrolled between February last year, a month before the COVID-19 national emergency began, and January 2021 — a 14% jump from previous enrollment stats.
By Rebecca Pifer • June 22, 2021 -
Adeline Kon/Healthcare Dive
Black patients were more likely to die of COVID-19 largely due to inferior hospitals
A recent study in JAMA Network Open showed how inequities in housing influence where Black people seek care and how that affects the quality of care they receive.
By Samantha Liss • June 21, 2021 -
Courtesy of Walmart
OpinionBetter data sharing among MCOs, public health, Medicaid could boost vaccination efforts
The CEO of Medicaid Health Plans of America says plans are already helping states manage and respond to the COVID-19 pandemic by using data analytics and demographic information to target outreach to those most at risk.
By Craig Kennedy • June 21, 2021 -
Medicare CGM eligibility widened in potential boon for Abbott, Dexcom
CMS opened up coverage for therapeutic continuous glucose monitors, eliminating a rule that patients must use a blood glucose monitor and require at least four self-monitoring blood glucose tests per day to have devices covered.
By Ricky Zipp • June 21, 2021 -
Jacob Bell / BioPharma Dive
FDA lays out device cybersecurity efforts as feds look to implement Biden executive order
The president signed an order last month seeking to bolster the nation's cyber posture amid growing threats from hackers.
By Greg Slabodkin • June 17, 2021 -
Stefani Reynolds / Stringer via Getty Images
MedPAC says lower clinical lab fees don't impact access, prompting industry ire
The clinical laboratory group, whose members include Quest and LabCorp, contends the report to Congress contains "biased" commentary that ignores the value of lab tests and importance of timely patient access.
By Nick Paul Taylor • June 17, 2021 -
Alex Wong via Getty Images
Hip, knee bundled pay program results similar as voluntary or mandatory: JAMA study
The results of a University of Pennsylvania analysis of more than a million Medicare claims for joint replacement surgery lend support to CMS' expected policy shift toward more mandatory bundled payment arrangements.
By Susan Kelly • June 16, 2021 -
State employee health plans know hospitals drive most costs, but struggle to make a dent
Most states instead focus on attempting to control prescription drug costs and lower utilization, according to the Georgetown University's Center on Health Insurance Reforms' poll.
By Shannon Muchmore • June 16, 2021 -
Stefani Reynolds / Stringer via Getty Images
MedPAC: Overhaul MA payments and streamline CMMI models
The group floated changing the Medicare Advantage benchmark calculation in its annual report to Congress, while Medicaid advisers separately suggested ways to curb specialty drug prices.
By Rebecca Pifer • June 16, 2021 -
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Majority of hospitals not complying with price transparency rule: JAMA
"Compliance may increase over time, but the early selective compliance suggests reluctance that may persist," researchers said, suggesting policymakers consider stiffer penalties than the current $300 a day fine.
By Rebecca Pifer • June 15, 2021
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