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FTC warns 21 healthcare marketers against deceptive claims
The warnings come less than a week after the fatal shooting of a UnitedHealthcare CEO unleashed expressions of anger on social media about health insurer practices.
By Maura Webber Sadovi • Dec. 10, 2024 -
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Premiums could rise, millions could lose coverage if enhanced ACA subsidies expire: CBO
The number of uninsured Americans will increase by 3.8 million on average each year from 2026 to 2034 if the subsidies lapse, according to an estimate by the Congressional Budget Office.
By Emily Olsen • Dec. 10, 2024 -
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TrendlineSurprise Billing
Federal legislation banning surprise bills has hit a barrage of roadblocks, complicating efforts to protect consumers from unexpected out-of-network charges.
By Healthcare Dive staff -
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FDA issues final guidance on postmarket updates to AI-enabled devices
By using pre-determined change control plans, manufacturers can update AI-enabled devices without filing an additional FDA submission.
By Elise Reuter • Dec. 4, 2024 -
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CMS recalculates Medicare Advantage stars for UnitedHealth, Centene
After both insurers challenged the agency in court, the CMS improved scores for 12 UnitedHealth contracts and seven Centene contracts.
By Rebecca Pifer Parduhn • Dec. 4, 2024 -
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8 experts on leveraging AI in healthcare
Healthcare organizations must carefully vet AI tools, address patient concerns and keep an eye on standards and regulation, according to industry experts who spoke at a Healthcare Dive virtual event.
By Sydney Halleman • Dec. 3, 2024 -
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CMS proposes new guardrails on Medicare Advantage prior authorizations, marketing
The Biden administration is attempting to push through a slew of reforms to the controversial MA program in its final months in power, though it will need the Trump administration’s buy-in to get them across the finish line.
By Rebecca Pifer Parduhn • Nov. 27, 2024 -
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Indiana health system withdraws merger application after regulator pushback
Union Health said it would submit a new Certificate of Public Advantage application to try to acquire Terre Haute Regional Hospital.
By Emily Olsen • Nov. 27, 2024 -
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HIPAA audits not effective at improving cybersecurity: OIG
The HHS’ Office for Civil Rights’ audit program was too narrow in scope to effectively assess data protections and reduce cyber risks in the healthcare sector, according to the report.
By Emily Olsen • Nov. 26, 2024 -
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Biden administration proposes Medicare, Medicaid coverage of pricey weight loss drugs
About 7.4 million Americans with obesity could have insurance coverage for drugs like Wegovy if the Trump administration allows the rule to go into effect — at the cost of $40 billion to federal and state governments.
By Rebecca Pifer Parduhn • Nov. 26, 2024 -
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CMS ordered to recalculate UnitedHealthcare’s 2025 MA stars
A Texas federal judge has sided with UnitedHealthcare in determining regulators messed up calculating its Medicare Advantage quality scores for next year. The decision could have big implications for similar pending cases.
By Rebecca Pifer Parduhn • Nov. 25, 2024 -
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Johns Hopkins surgeon Makary is Trump’s pick to lead FDA
A prolific medical researcher and author, Martin Makary criticized the FDA and CDC for their decision-making during the pandemic, although he describes himself as pro-vaccine.
By Jonathan Gardner , Ned Pagliarulo • Nov. 23, 2024 -
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Hospital price transparency continues to drop: report
Just 21.1% of hospitals are in full compliance with federal price transparency rules, according to Patient Rights Advocate. Compliance has slipped since July 2023.
By Susanna Vogel • Nov. 22, 2024 -
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UnitedHealth, Cigna, CVS sue FTC over insulin litigation process
The three companies are claiming the FTC’s suit is unconstitutional because it was lodged in the agency’s administrative court, instead of a federal one.
By Rebecca Pifer Parduhn • Nov. 20, 2024 -
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CMS allows 5 states to adopt multiyear continuous Medicaid eligibility for children
The future of such policies is unclear under an upcoming Trump administration, which could rescind approvals or prevent states from implementing waivers.
By Emily Olsen • Nov. 20, 2024 -
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RFK Jr.'s path to HHS secretaryHealthcare industry braces for RFK Jr.
Kennedy's views on vaccines in particular are causing alarm among some physicians and investors.
By Susanna Vogel • Nov. 20, 2024 -
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Trump nominates Dr. Oz to oversee Medicare, Medicaid as CMS head
On Truth Social, President-elect Donald Trump said Oz, who is best known for his eponymous TV show, would take on the “illness industrial complex.”
By Sydney Halleman • Updated Nov. 20, 2024 -
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HHS facing challenges as lead agency for healthcare cybersecurity: GAO
The department hasn’t implemented some policies recommended by the watchdog, which could pose a risk to cybersecurity in the sector as attacks increase, according to the Government Accountability Office.
By Emily Olsen • Nov. 19, 2024 -
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If enhanced ACA subsidies expire, 4M could become uninsured: report
The enhanced premium tax credits will expire at the end of next year without action from lawmakers. Republicans have previously criticized the subsidies’ cost.
By Emily Olsen • Nov. 19, 2024 -
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Eli Lilly follows J&J in suing Biden administration over 340B rebates
Major drugmakers are filing lawsuits against the HHS and HRSA to try to resuscitate plans to issue hospitals rebates instead of giving them upfront discounts on 340B drugs.
By Rebecca Pifer Parduhn • Nov. 18, 2024 -
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Offering health insurance is becoming less lucrative
In the third quarter, the seven major publicly traded insurers’ medical loss ratios increased an average of 3.3 percentage points year over year — a major jump in medical costs.
By Rebecca Pifer Parduhn • Nov. 18, 2024 -
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DEA, HHS issue another extension for telehealth controlled substance prescribing
The third temporary extension, which prolongs the pandemic-era flexibilities through the end of 2025, is a relief for telehealth groups who had raised concerns about access to medications.
By Emily Olsen • Nov. 18, 2024 -
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RFK Jr.'s path to HHS secretary
Trump nominates RFK Jr. to lead HHS
The nomination of a prominent vaccine skeptic to the head of the nation’s largest healthcare program is expected to alarm some public health experts.
By Sydney Halleman • Nov. 14, 2024 -
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Top CMS official urges Trump administration to treat Medicaid with care
“Do to others what you would want done to yourself,” Medicaid director Daniel Tsai said Thursday when asked about advice for his replacement in Trump’s HHS. Trump is expected to cut Medicaid eligibility and funding.
By Rebecca Pifer Parduhn • Nov. 14, 2024 -
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CMS to lower importance of ‘call center’ metric in Medicare Advantage star ratings
Regulators’ assessment of customer support centers has spurred recent lawsuits from insurers. But the metric “is going to have a smaller weighting on star ratings moving forward,” the director of Medicare said.
By Rebecca Pifer Parduhn • Updated Nov. 15, 2024 -
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Tenet CEO looks ahead to second Trump term
Saum Sutaria doesn't think the ACA marketplace is going anywhere under President-elect Donald Trump, noting beneficiaries are an “important part of the electorate” for the incoming administration.
By Susanna Vogel • Nov. 13, 2024
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