Government: Page 26
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Rebecca Pifer/Healthcare Dive
CMS finalizes notice on Medicare coverage for breakthrough devices
The CMS will consider five medical device candidates yearly for national coverage through the new pathway, called Transitional Coverage for Emerging Technologies.
By Elise Reuter • Aug. 8, 2024 -
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Uninsured rate jumps to 8.2% amid Medicaid unwinding: CDC
Growth in the nation’s uninsured rate could become steeper if subsidies in the Affordable Care Act exchanges expire on schedule next year, according to health policy experts.
By Rebecca Pifer Parduhn • Aug. 7, 2024 -
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Surprise BillingAppeals court hands providers latest win in No Surprises litigation
The 5th Circuit Court’s decision vacates instructions that arbiters should first consider the qualifying payment amount in deciding payments over contested out-of-network bills. Providers argued that unfairly advantaged insurers.
By Rebecca Pifer Parduhn • Aug. 6, 2024 -
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Experts fear patient harm from FDA’s lab developed test rule
Decreased access to diagnostic tests, worsening patient care and practice closures are among the concerns the AMA and others have raised as the regulation takes effect.
By Susan Kelly • Aug. 5, 2024 -
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Disadvantaged areas less likely to have high-quality Medicare Advantage plans, study finds
The research, which found socially vulnerable counties were more likely to have MA plans rated under 3.5 stars, is the latest highlighting the importance of location in healthcare access.
By Rebecca Pifer Parduhn • July 31, 2024 -
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North Carolina to offer enhanced Medicaid funds to hospitals that help eliminate medical debt
The incentive program offers hospitals a carrot for relieving debt that health systems were unlikely to recover anyway, with experts labeling the program a “win-win” for patients and providers.
By Susanna Vogel • July 31, 2024 -
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Mental telehealth services have declined since end of pandemic emergency: study
The JAMA study comes as lawmakers debate whether to permanently expand telehealth flexibilities in Medicare this year.
By Sydney Halleman • July 30, 2024 -
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OpinionThe Senate can protect the elderly by supporting nursing home staffing regulations — not overturning them
Lawmakers must uphold minimum staffing requirements for nursing homes to ensure quality care for the elderly, argues one legal expert.
By Ed Dudensing • July 29, 2024 -
Susanna Vogel/Healthcare Dive, data from Susanna Vogel
Tracking Steward's declineSenate committee subpoenas Steward CEO over bankruptcy
The Health, Education, Labor and Pensions committee launched an investigation into the health system’s alleged financial mismanagement after issuing its first subpoena since 1981.
By Susanna Vogel • July 26, 2024 -
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Lawmakers question resuming VA Oracle EHR rollout at subcommittee hearing
Deployments of the new electronic health record have largely been on hold, except for the recent launch at a medical center in Illinois. Agency and Oracle officials said the rollout went well.
By Emily Olsen • July 25, 2024 -
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HHS reorganizes technology functions, renames ONC
The revamp should help the department handle pressing challenges facing the healthcare sector, like cyber threats and the growth of AI, HHS Secretary Xavier Becerra said.
By Emily Olsen • July 25, 2024 -
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Warren, Democratic lawmakers introduce bill to resurrect Chevron doctrine
The Stop Corporate Capture Act would codify the Chevron doctrine, which required federal courts to defer to agencies’ reasonable interpretation of ambiguous statutes.
By Ginger Christ • July 24, 2024 -
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PBMs battle bipartisan scrutiny as lawmakers eye industry reform
Top executives of CVS Caremark, Optum Rx and Express Scripts made a rare congressional appearance to defend pharmacy benefit managers’ drug pricing policies.
By Susanna Vogel , Rebecca Pifer Parduhn • July 24, 2024 -
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CMS cracks down on ACA brokers to prevent plan switching
Agents and brokers connecting consumers with Affordable Care Act plans now have to jump new hurdles to change their coverage, following mounting complaints about unauthorized plan switching.
By Rebecca Pifer Parduhn • July 22, 2024 -
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UnitedHealthcare, Neighborhood Health Plan win Rhode Island Medicaid contracts
The state’s managed care organizations handle health benefits for 90% of its Medicaid beneficiaries each year.
By Emily Olsen • July 18, 2024 -
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Senators introduce bipartisan healthcare cybersecurity legislation
The bill would create a special liaison within the Cybersecurity and Infrastructure Security Agency to help coordinate the government’s response during cyber incidents.
By Emily Olsen • July 16, 2024 -
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House committee tells FDA to suspend lab developed test rule
Lawmakers said the final rule carries “the risk of greatly altering the United States’ laboratory testing infrastructure.”
By Nick Paul Taylor • July 15, 2024 -
Surprise BillingCMS’ first No Surprises audit targets Aetna, finds some noncompliance
The findings are a “big deal,” according to one expert, as CVS’ health insurer didn’t follow some “major requirements that are essential to ensuring that the IDR process runs smoothly.”
By Rebecca Pifer Parduhn • July 12, 2024 -
Courtesy of HHS
ONC proposed rule targets interoperability for public health, payers
The sweeping rule includes provisions to improve public health data sharing — a serious pain point during the COVID-19 pandemic — as well as to boost security in health records and speed prior authorization.
By Emily Olsen • July 11, 2024 -
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Deep DiveFDA’s lab developed test rule could be first check on agency’s power post-Chevron
The Supreme Court’s decision to overturn the Chevron doctrine would make it easier to challenge agency regulations, such as the LDT final rule.
By Susan Kelly , Elise Reuter • July 11, 2024 -
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CMS proposes 2.9% cut to physician pay for 2025
Regulators said Medicare’s budget neutrality requirement is to blame for the reduction, which was quickly decried by provider groups. However, it’s likely Congress will step in to mitigate the drop.
By Rebecca Pifer Parduhn • July 11, 2024 -
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Federal Trade Commission to sue three largest PBMs: WSJ
Antitrust regulators are poised to file suit against CVS Caremark, Express Scripts and Optum Rx over how they negotiate discounts for drugs, including insulin, according to the report.
By Rebecca Pifer Parduhn • July 10, 2024 -
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Judge pauses CMS rule capping compensation for Medicare Advantage brokers
Texas Judge Reed O’Connor’s decision suggests he could overturn at least part of the rule, which is meant to curb predatory plan marketing to seniors.
By Rebecca Pifer Parduhn • July 10, 2024 -
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Medicare proposes 2.6% bump to hospital outpatient pay next year
The sweeping payment rule also solidifies continuous eligibility requirements for children in Medicaid and CHIP, and holds hospitals to higher obstetric care delivery standards in a bid to improve maternal mortality.
By Rebecca Pifer Parduhn • July 10, 2024 -
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Federal officials step down from health AI group’s board
HHS officials Micky Tripathi and Troy Tazbaz resigned from their roles as non-voting members of the Coalition for Health AI, an industry group working to create standards for artificial intelligence in healthcare.
By Emily Olsen • July 9, 2024
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