Biden administration announces appeal to ACA preventive mandate ruling

The Justice Department on Friday appealed a Texas judge's ruling that struck down part of the ACA requiring health plans to fully cover certain preventive medical services like HIV drugs and cancer screenings.

By Hailey Mensik • April 3, 2023

CMS increases MA rate bump for 2024

Risk adjustment changes will now be phased in over three years, after payers pushed back on the proposed payment rule.

By Shannon Muchmore • April 3, 2023

Explore the Trendline➔

Labor

Hospitals are navigating persistent labor shortages with the need to cut costs — a source of contention that could leave patients caught in the middle.

By Healthcare Dive staff

Biden’s latest drug price control plans threaten war on cancer, Alzheimer’s and more

Former Clinton health policy adviser Kenneth Thorpe argues that federal price control policies could wreak havoc in the industry.

By Kenneth E. Thorpe • March 31, 2023

FDA approves Narcan for over-the-counter use

It’s the first time a naloxone-based therapy for opioid overdoses has been cleared for use without a prescription, potentially helping to improve access.

By Delilah Alvarado • March 30, 2023

Judge tosses ACA preventive care mandate

The Thursday ruling means that, effective immediately, health plans nationwide are no longer required to fully cover certain preventative medical services like cancer, HIV and diabetes screenings.

By Hailey Mensik • March 30, 2023

Warren calls on CMS to finalize MA payment change

Insurance and provider lobbies called on the CMS to delay the rule earlier this month, saying the methodology was flawed and arguing the 30-day comment period didn't give them enough time to analyze the proposed changes.

By Shannon Muchmore • March 29, 2023

AHIP, AHA join forces in amicus brief to SCOTUS False Claims Act case

The groups argue the expansion of the FCA would threaten the “legitimate business activities of every government contractor, hospital, healthcare provider, health insurance provider, and grant recipient in the nation.”

By Sydney Halleman • March 29, 2023

Ohio AG sues ‘modern gangsters’ Cigna, Humana for alleged PBM price fixing

Ohio Attorney General David Yost filed suit on Monday against the payers' PBMs, along with Prime Therapeutics, for allegedly sharing pricing information and driving up drug prices.

By Hailey Mensik • March 28, 2023

North Carolina becomes 40th state to expand Medicaid

The expansion puts an end to a decade-plus political battle in North Carolina over Medicaid and illustrates mounting support for the program.

By Rebecca Pifer • March 27, 2023

FDA details plan to end emergency use authorizations

The agency is providing a 180-day transition period for devices that were exempted during the pandemic, and said companies that currently have an EUA should start preparing.

By Elise Reuter • March 24, 2023

HIPAA reform should protect patients, scale back silos around medical data

Lifespark chief executive Joel Theisen argues for an update of HIPAA that acknowledges an advanced technology landscape and gives providers a fuller picture of patient health.

By Joel Theisen • March 24, 2023

Moderna CEO defends price of COVID shot at Senate hearing

Stéphane Bancel said his company’s planned price hike covers the higher costs of commercial sales. Sen. Bernie Sanders called it part of industry’s “unprecedented level of corporate greed.”

By Christopher Newman • March 22, 2023

Delays in reporting led FDA to late cancer warning on breast implants, advocates say

Cases need to be better tracked, and the cancer risks should be discussed with patients prior to surgery, patient advocates and physicians said.

By Elise Reuter • March 22, 2023

DOJ drops appeal against UnitedHealth’s acquisition of Change

In a Monday filing with a federal appeals court, the DOJ-led group agreed to withdraw its suit against a ruling that had allowed the merger.

By Sydney Halleman • March 22, 2023

Arbiters instructed to resume No Surprises Act determinations

The CMS had previously paused and resumed earlier disputes between payers and providers after a Texas judge ruled against the federal government and vacated portions of the law that bans surprise billing.

By Sydney Halleman • March 21, 2023

Wyoming bans abortion pills

It is the first state to specifically prohibit the pills, which make up half of all abortions in the U.S. The ban comes before an expected decision by a Texas judge that could force manufacturers to pull one pill from markets nationwide.

By Rebecca Pifer • March 20, 2023

Transforming veteran healthcare: How telehealth is changing the game

Discover how telehealth is revolutionizing veteran healthcare, providing high-quality care regardless of location with essential use cases like video consultations, remote monitoring and telestroke.  

By Matt Wall, Director, Business Development, Tryten Technologies • March 20, 2023

CMS lays out plans for negotiating drug prices

The guidance fills in details for one of the central pharmaceutical provisions of the Inflation Reduction Act, signaling how the agency will use its new authority.

By Christopher Newman • March 16, 2023

Majority of states plan to take their time with Medicaid redeterminations

Some states are proposing to unwind Medicaid coverage more slowly, while others are moving more quickly to focus on reducing budgetary costs, according to a survey from the Kaiser Family Foundation.

By Rebecca Pifer • March 16, 2023

MedPAC recommends physician pay bump, but not enough for provider groups

Updating base physician payment rates by 1.45% in 2024 as proposed by the group that advises Congress on Medicare policy is “grossly insufficient,” the Medical Group Management Association said.

By Hailey Mensik • March 16, 2023

US names first drugs to face price hike penalty

Under the Inflation Reduction Act, pharma companies owe rebates to Medicare for price increases they take that exceed inflation. But they won’t need to pay until 2025.

By Christopher Newman • March 15, 2023

FTC says health privacy key priority in 2024 budget request

The agency cited its need to take on bigger and more complex cases in areas like health privacy in its request on Tuesday for a $160 million funding boost.

By Rebecca Pifer • March 15, 2023

VA to cover Leqembi for veterans with early Alzheimer’s

The agency’s decision on Eisai and Biogen’s newly approved drug contrasts with a stringent Medicare policy that limits coverage to only patients in clinical trials.

By Christopher Newman • March 14, 2023

Democrat senators press major US pharmacies on mifepristone access

The letters, sent to Walgreens, CVS, Rite Aid, Albertsons, Walmart, Kroger and Costco, urge the chains to clarify their positions on dispensing the abortion pill.

By Rebecca Pifer • March 14, 2023

Physicians say prior authorization rules harm patients, AMA survey finds, as CMS works toward new policy

Over a third of physicians said the requirements led to a serious adverse event for one of their patients, such as hospitalization, permanent impairment or death, the survey found.

By Hailey Mensik • March 14, 2023