North Carolina places Friday Health Plans into receivership as insurtech shuts down

A number of states have already moved to take control of the insurer, which announced it was winding down operations earlier this month.

By Emily Olsen • June 22, 2023

State Medicaid spending fell below pre-pandemic levels during continuous enrollment

An analysis by KFF found state spending on Medicaid fell during the COVID-19 pandemic even as enrollment soared. But spending will likely increase as the federal government begins to pare back its increased contribution.

By Emily Olsen • June 21, 2023

HHS warns industry about resurfaced ransomware group after attack on cancer center

The department sent a cybersecurity notification to the sector about TimisoaraHackerTeam after an attack on a U.S. cancer center that “significantly reduced” its capability to treat patients.

By Emily Olsen • June 21, 2023

Biden taps Aledade executive Mandy Cohen to succeed Walensky as CDC director

Cohen was previously secretary of North Carolina’s Department of Health and Human Services, and drew praise for her leadership during the COVID-19 pandemic.

By Brian T. Horowitz • June 20, 2023

MedPAC recommends return to lower telehealth payments

The group that advises Congress on Medicare policy also suggested more closely setting payment rates across outpatient facilities for some services, which hospital lobbyists oppose.

By Emily Olsen • June 16, 2023

Biden administration should not wait to provide access to non-opioid pain management

A surgeon and assistant professor argues that the CMS and providers must collaborate to enhance access to non-opioid pain alternatives.

By Nirav Amin • June 16, 2023

US health spending to surpass $7T by 2031, CMS actuaries say

The unwinding of the COVID-19 public health emergency and recent legislation are expected to influence health spending across the country’s major payers over the next decade.

By Rebecca Pifer • June 15, 2023

New York to approve staffing requirement in critical care units

On Thursday, New York is expected to greenlight a component of its 2021 staffing law that requires one nurse for every two critical care patients.

By Susanna Vogel • June 15, 2023

New York becomes 35th state to extend Medicaid, CHIP postpartum coverage

The extension guarantees access to care for 12 months following pregnancy — up from the previously guaranteed 60 days.

By Susanna Vogel • June 14, 2023

Medicare Advantage overpayments could exceed $75B this year, study finds

The figure is almost triple prior estimates, highlighting the need for payment reform to avoid overtaxing the Medicare system, researchers said.

By Emily Olsen • June 14, 2023

Expanded federal safety net during COVID led to improved health access for adults, report finds

Between 2019 and 2022, fewer adults reported taking on medical debt or forgoing medical care due to cost, according to the Robert Wood Johnson Foundation.

By Susanna Vogel • June 13, 2023

HHS offers aid amid Medicaid redetermination coverage losses

Secretary Xavier Becerra urged states to adopt new flexibilities to limit Medicaid churn, adding in a letter to state governors that he's "deeply concerned" about unnecessary coverage losses.

By Emily Olsen • June 13, 2023

CMS exploring models centered on social health factors

Regulators said they’re trying to work around restrictions regarding what groups Medicare is allowed to pay as they look to address social determinants of health.

By Rebecca Pifer • June 9, 2023

The public health emergency is over. Here’s why government must prioritize funding for long COVID research.

University of Arizona professors argue for more robust infrastructure to understand and research long COVID-19, which affects one in five Americans.

By Kristen Pogreba Brown, Leslie V. Farland and Jennifer Andrews • June 9, 2023

CMS launches primary care pilot to expand value-based care

The Making Care Primary Model, which will begin next summer in eight states, aims to strengthen primary care delivery, particularly for safety net and small or independent organizations.

By Emily Olsen • June 9, 2023

Insurers report stable performance amid industry headwinds, but cost pressures loom

Provider cost pressures are weighing on the nation's largest insurers, with contract negotiations possibly forcing premiums higher over the next few years, according to Fitch Ratings.

By Sydney Halleman • June 7, 2023

FTC urges North Carolina legislators to drop UNC Health antitrust exemption bill

The bill’s sponsor previously told local media that it could give the nonprofit, state-owned system the chance to save struggling rural hospitals.

By Emily Olsen • June 7, 2023

Merck sues to stop Medicare negotiation of drug prices

The drugmaker’s lawsuit claims the new pricing powers granted by the Inflation Reduction Act are unconstitutional and “tantamount to extortion.”

By Christopher Newman • June 6, 2023

Friday Health Plans to shut down as state regulators step in

In a statement, the insurer said it was “unable to scale our financial infrastructure to match the pace of our growth and secure the additional capital required to run our business.”

By Emily Olsen • June 5, 2023

Biden signs debt deal, clearing path for $27B in COVID-19 clawbacks

Some of the funding is healthcare-related, and major programs like Medicaid and Medicare emerged unscathed after weeks of negotiations between Republicans and Democrats.

By Rebecca Pifer • June 5, 2023

Tenet to pay over $29M to settle kickback allegations at Detroit Medical Center

The Department of Justice alleged two DMC hospitals offered the services of mid-level practitioners to physicians in exchange for Medicare patient referrals.

By Emily Olsen • June 2, 2023

Over half a million disenrolled amid Medicaid redeterminations so far

A KFF analysis of 11 states found many of the people who have already been removed from the Medicaid program were disenrolled for procedural reasons.

By Emily Olsen • June 1, 2023

Medicare keeps limits on Alzheimer’s drug coverage, but loosens policy

The agency will reimburse Alzheimer’s treatments if they receive full FDA approval, but plans to still require data collection via a patient registry.

By Christopher Newman • June 1, 2023

Postpartum people could lose coverage amid Medicaid redeterminations

People in some states could lose postpartum coverage 60 days after giving birth, even though health risks from pregnancy can continue for months, according to a new report from KFF.

By Emily Olsen • May 30, 2023

Healthcare provisions of the debt limit deal: COVID-19 funding clawbacks, no Medicaid work requirements

Congressional Republicans and the White House reached a deal over the weekend to raise the debt ceiling that includes healthcare policy wins for both sides of the aisle.

By Rebecca Pifer • May 30, 2023