Government: Page 3


  • A view of the historic Old Florida State Capitol building, which sits in front of the current New Capitol, on November 10, 2018 in Tallahassee, Florida.
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    Florida sued over Medicaid redeterminations

    Three Floridians, including two children, filed a lawsuit against the state on Tuesday alleging it illegally cut their Medicaid coverage without proper notice.

    By Aug. 23, 2023
  • Boehringer sues to block US drug price program

    The pharma’s suit, which claims Medicare’s new power to negotiate certain drug prices is unconstitutional, comes days before the agency will reveal the first 10 medicines to be included under the plan.

    By Ned Pagliarulo • Aug. 22, 2023
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    Trendline

    Surprise 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
  • Keith Ellison AG
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    Minnesota AG launches investigation into Allina Health’s billing practices

    Allina Health will "formally transition away” from its policy of interrupting non-emergency, outpatient care for patients with debt, a spokesperson said. The announcement will not affect the Minnesota investigation.

    By Updated Aug. 23, 2023
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    TheaDesign/iStock/Getty Images Plus via Getty Images
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    Ground ambulance billing committee skeptical of IDR process

    A key congressional advisory group met last week to deliberate preventing unexpected bills after medical transport, but said the status quo dispute resolution process isn’t the solution.

    By Aug. 17, 2023
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    Anna Moneymaker via Getty Images
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    Overturning of Roe v. Wade

    Appeals court rules to limit abortion pill access

    Federal judges disagreed with a lower court decision suspending the pill’s approval, but said recent changes that loosened prescribing rules should be rolled back.

    By Aug. 16, 2023
  • A picture of the exterior of the US Department of Health and Human Services. In front of the building is a black sign designating the building's name.
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    Alex Wong via Getty Images
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    CMS tweaks ACO REACH to stabilize model

    Regulators lowered enrollment minimums for accountable care organizations in the program, which allows providers to form groups to manage care and costs for fee-for-service Medicare enrollees.

    By Aug. 15, 2023
  • A stethoscope rests on a medical insurance claim form.
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    Deep Dive

    Will the Biden administration’s short-term plan rule increase the uninsured rate?

    Free-market advocates argue proposed restrictions on short-term plans will leave consumers without coverage. Health policy researchers aren’t so sure.

    By Aug. 14, 2023
  • UnitedHealth Group's headquarters building in Minnetonka, Minnesota.
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    UnitedHealth Group
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    DOJ hits UnitedHealth, Amedisys with second request over $3.3B deal

    The request for more information pushes back the timeline of the merger as regulators take a more active stance in healthcare M&A oversight.

    By Aug. 11, 2023
  • People in scrubs and street clothes sit in an auditorium in front of a lecturer.
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    HHS pledges more than $100M to grow nursing workforce

    The investment aims to reduce bottlenecks in nurse training that stakeholders say hamper recruitment efforts.

    By Aug. 10, 2023
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    dventtr via Getty Images
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    MA bonuses reach record high, with UnitedHealthcare, Humana biggest winners

    Star ratings bonuses reached $12.8 billion, according to the KFF, as the Medicare program faces a growing spending crisis.

    By Aug. 10, 2023
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    Senators crack down on nonprofit hospitals’ charity care, tax-exempt status

    The letter, sent by a bipartisan group of senators to tax commissioners, comes as the federal government increases scrutiny into nonprofit hospitals’ charity care spending.

    By Aug. 9, 2023
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    Mark Wilson via Getty Images
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    Texas judge rules in favor of doctors in latest suit over surprise billing process

    The decision is expected to increase the number of claims providers file in the independent dispute resolution process, especially for smaller amounts, according to a health lawyer.

    By Aug. 7, 2023
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    DEA open to considering special registration for telehealth controlled substance prescriptions

    The announcement comes after the agency received more than 38,000 public comments in response to a proposal that would restrict telehealth prescriptions, with “a significant majority” expressing concern.

    By Aug. 7, 2023
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    nopparit via Getty Images
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    FDA approves Sage, Biogen drug for postpartum depression, but rejects wider use

    The approval of Zurzuvae marks the first time the FDA has approved a pill for postpartum depression.

    By Jacob Bell • Aug. 5, 2023
  • A calculator and stethoscope rest on a medical bill.
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    erdikocak via Getty Images
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    Health insurers ignore surprise billing decisions, providers allege

    Payers didn’t reimburse doctors in more than half of arbitration award cases, according to a survey from clinician group Americans for Fair Health Care.

    By Aug. 4, 2023
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    Kentucky sues major PBMs over rising insulin prices

    A string of states and cities have filed recent suits against PBMs and drug manufacturers alleging they work in tandem to raise the cost of insulin.

    By Aug. 4, 2023
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    Stock Photo via Getty Images
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    UnitedHealth unit sued by Labor Department over systematic claims denials

    The government is alleging plan administrator UMR improperly denied thousands of ER and drug screening claims submitted between 2015 and 2018.

    By Aug. 2, 2023
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    Fotolia
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    CMS finalizes 3.1% inpatient payment bump for hospitals

    Hospitals decried the rate adjustment, which is higher than the 2.8% proposed earlier this year, as out of touch with their financial reality.

    By Aug. 2, 2023
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    Hospital, payer lobbies urge CMS to reconsider ‘conflicting’ prior authorization standards

    The groups, normally at odds, have found a source of agreement in proposed rules meant to standardize data exchange processes.

    By July 31, 2023
  • a medicaid insurance card on top of a small American flag
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    CMS releases April Medicaid unwinding data. Total disenrollments top 3.8M

    The highly-anticipated data pegging the nation’s procedural disenrollment rate at 80% is higher than more recent estimates.

    By July 28, 2023
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    Alex Wong via Getty Images
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    CMS says data of 612K Medicare beneficiaries affected in MoveIt breach

    A data breach earlier this year has affected tens of millions of individuals to date, and also compromised the sensitive personal and medical information of Medicare seniors.

    By July 28, 2023
  • A prescription bottle with white pills and a wooden gavel sit atop a $100 bill showing Benjamin Franklin's face.
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    Bill Oxford via Getty Images
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    FTC reaches proposed settlement with Surescripts in antitrust case

    The lawsuit alleged the health IT vendor monopolized e-prescription drug markets for routing and eligibility through exclusivity agreements, threats and other exclusionary conduct.

    By July 28, 2023
  • A calculator and stethoscope rest on a medical bill.
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    Nevada to shut down Friday Health Plans

    State regulators will liquidate the failing insurtech, leaving about 3,000 enrollees to look for new coverage.

    By July 27, 2023
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    Joe Raedle via Getty Images
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    Cleveland sues major PBMs, drug manufacturers over rising insulin prices

    The suit argues that PBMs, including CVS Caremark, Express Scripts and OptumRx, use their market power to drive up the cost of insulin for Cleveland residents — approximately 17% of whom are diabetic. 

    By July 26, 2023
  • Biden stands behind a podium wearing a navy suit.
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    Biden administration cracks down on payers over mental health coverage

    A new proposed rule from the HHS and Treasury and Labor departments would require health insurers to analyze patient outcomes to ensure their benefits are administered equally.

    By July 25, 2023