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Humana pays $90M to settle whistleblower allegations of Medicare Part D fraud
The insurer, which did not admit wrongdoing, agreed to the deal on the eve of a jury trial.
By Rebecca Pifer Parduhn • Aug. 20, 2024 -
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FTC noncompete ban suffers another blow
The ruling — which applies only to one Florida-based real estate broker — comes just weeks before the ban is slated to take effect.
By Ryan Golden • Aug. 19, 2024 -
Explore the Trendline➔
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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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Tracking Steward's declineMassachusetts makes deal to force Steward hospital sales
Gov. Maura Healey’s office has brokered agreements for Steward to sell five hospitals to other operators, ensuring they’ll remain open as the health system’s bankruptcy proceedings drag on.
By Rebecca Pifer Parduhn • Aug. 19, 2024 -
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Court strikes down HHS change to low-income payment formula in win for Texas hospitals
The case centered on whether patients who receive funds from a pool of state money for uncompensated care could be included in calculating hospitals’ disproportionate share funding.
By Rebecca Pifer Parduhn • Aug. 19, 2024 -
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Medicare drug price cuts could have limited early impact, but grow with time
Some industry watchers described the level of price discounts announced by Medicare as a "relief," though they warned of bigger future implications for drug research.
By Jonathan Gardner • Aug. 16, 2024 -
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Texas sues Biden administration over nursing home staffing mandate
It’s the latest legal challenge against the mandate finalized this spring, which requires long-term care facilities to provide at least 3.48 hours of care per resident each day.
By Rebecca Pifer Parduhn • Aug. 15, 2024 -
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Medicare reveals results of drug price negotiations
The agency said the first round of pricing talks, which involved drugs like the blood thinners Eliquis and Xarelto, will result in $6 billion in savings for taxpayers.
By Ned Pagliarulo • Aug. 15, 2024 -
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Overturning of Roe v. WadeTexas women say hospitals violated EMTALA by denying emergency abortions
The patients’ complaints to the HHS allege two Texas hospitals denied them emergency abortion care for ectopic pregnancies, risking their lives and damaging their future fertility.
By Emily Olsen • Aug. 13, 2024 -
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In tone-setting verdict, FDA rejects MDMA as a therapy aid for PTSD
The decision to turn down an application comes at a pivotal time for psychedelics research, which has recently gained momentum after decades of dismissal.
By Jacob Bell • Updated Aug. 9, 2024 -
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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 Billing
Appeals 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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