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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 -
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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 -
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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CMS revised Medicare Advantage star ratings. Here’s which payers benefited.
More than 60 Medicare Advantage health plans from 40 insurers have received a higher star rating for 2024, according to a Healthcare Dive analysis.
By Rebecca Pifer Parduhn • July 9, 2024 -
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Federal judge blocks LGBTQ+ healthcare protections
The judge ruled the HHS overstepped in applying an employment law decision to healthcare, a decision experts say could occur more frequently now that the Chevron doctrine has been overturned.
By Susanna Vogel • July 9, 2024 -
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FTC slams pharmacy benefit managers in first report from ongoing investigation
The report is not positive for the drug middlemen, which immediately criticized it as one-sided.
By Rebecca Pifer Parduhn • July 9, 2024 -
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FTC noncompete ban partially blocked by Texas judge
The ban has wide-ranging consequences for healthcare, an industry that frequently utilizes noncompetes.
By Ryan Golden • July 3, 2024 -
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Hackensack Meridian Health files lawsuit in wake of Chevron decision
Experts predict a wave of litigation will follow the Chevron ruling, which raised the bar for healthcare agencies when implementing laws with unclear intent.
By Susanna Vogel • July 3, 2024 -
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Medicaid redeterminations1 in 8 enrollees exited Medicaid during redeterminations in 4 Southern states: study
The survey, which included low-income people in Arkansas, Kentucky, Louisiana and Texas, found about half of those who were no longer enrolled in Medicaid were uninsured in late 2023.
By Emily Olsen • July 3, 2024 -
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SCOTUS strikes down Chevron doctrine, curbing federal agency power
The court’s controversial decision raises the bar for healthcare regulators when they’re implementing laws with undefined terms — and opens the door for more lawsuits from stakeholders unhappy with an agency’s reading of a statute.
By Rebecca Pifer Parduhn • June 28, 2024 -
Courtesy of UnitedHealth Group
Optum Rx reaches $20M settlement with Justice Department over opioid prescribing
The UnitedHealth pharmacy benefit manager did not have to admit guilt as part of the settlement, which amounts to a minuscule fraction of its annual revenue.
By Rebecca Pifer Parduhn • June 28, 2024 -
Walter Bibikow
Supreme Court allows emergency abortions in Idaho, sidestepping broader EMTALA questions
The Supreme Court declined to issue broad guidance on how to adjudicate conflicts between state abortion laws and a federal law requiring hospitals provide patients with emergency care.
By Susanna Vogel • June 26, 2024 -
Walter Bibikow
Tennessee’s ban on gender-affirming care for minors heads to Supreme Court
The case could have ripple effects across the country, where 25 states have similar laws on the books, according to the Human Rights Campaign.
By Susanna Vogel • June 25, 2024 -
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Arkansas sues Optum, Express Scripts over role in opioid epidemic
Pharmacy benefit managers have largely avoided the brunt of public blame for the deadly opioid crisis. Arkansas’ lawsuit brings the drug middlemen back to the forefront of the controversy.
By Rebecca Pifer Parduhn • June 25, 2024 -
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HHS finalizes info blocking penalties for providers
Providers pushed back against the disincentives, with the Medical Group Management Association calling them “unnecessarily punitive.”
By Emily Olsen • June 25, 2024 -
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Federal judge sides with providers, nixes online tracker guidance
A federal court in Texas ruled regulators exceeded their authority in limiting providers’ use of online tracking technologies.
By Emily Olsen • June 24, 2024 -
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Appeals court upholds ACA’s preventive services mandate, but opens door to future challenges
The Fifth Circuit Court of Appeals’ decision Friday is a win for the upwards of 150 million people that receive health insurance through their employers. However, it paves the way for future lawsuits from opponents of the ACA.
By Rebecca Pifer Parduhn • June 24, 2024 -
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Steward further extends asset sale timeline. More delays could follow.
Steward has again delayed the sale timeline for several of its assets, including its physician group Stewardship Health.
By Susanna Vogel • Updated July 16, 2024 -
Courtesy of HHS
Q&A
ONC’s Micky Tripathi on laying the digital floor for healthcare AI
The agency head discussed ONC’s accomplishments over the past two decades, improving documentation burden among clinicians and artificial intelligence opportunities.
By Emily Olsen • June 20, 2024
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