DEA temporarily extends telehealth prescribing rules for controlled substances again

The Drug Enforcement Administration and the HHS announced they would extend pandemic-era flexibilities for prescribing controlled substances virtually through the end of 2024.

By Emily Olsen • Oct. 9, 2023

Aetna may have received $25.5M in MA overpayments for 2015 and 2016, audit finds

Medical records provided by the insurer didn’t support certain diagnosis codes, resulting in overpayments, according to an audit from the HHS Office of the Inspector General.

By Emily Olsen • Oct. 6, 2023

Warren, Jayapal call for closer scrutiny of UnitedHealth-Amedisys deal

The progressive lawmakers sent a letter to top antitrust regulators urging heightened attention to the $3.3 billion transaction, which is currently under investigation by the Department of Justice.

By Rebecca Pifer Parduhn • Oct. 4, 2023

AHA urges lawmakers to roll back online tracking tech restrictions

The hospital lobby argued recent guidance limiting third-party tracking technology prevents providers from sharing reliable healthcare information.

By Emily Olsen • Oct. 2, 2023

Cigna pays $172M to settle MA upcoding allegations

The agreement settles a whistleblower lawsuit against Cigna that the Department of Justice joined last year, and requires the payer to undergo annual auditing from an independent entity.

By Rebecca Pifer Parduhn • Oct. 2, 2023

CMMI increased federal spending by $5.4B during its first decade, report finds

The Congressional Budget Office report estimated the Center for Medicare and Medicaid Innovation, which was created in part to reduce spending, will increase net federal spending by $1.3 billion from 2021 through 2030.

By Emily Olsen • Sept. 29, 2023

Congressional Democrats open investigation into Medicaid MCOs over claims denials

Sen. Ron Wyden, D-Ore., and Rep. Frank Pallone, D-N.J., sent letters requesting information on coverage denials to seven payers, including UnitedHealthcare, Aetna and Centene.

By Rebecca Pifer Parduhn • Sept. 29, 2023

A matter of trust: More delays for the VA’s EHR system

Shira Fischer, a physician policy researcher at the Rand Corporation, discusses why user trust is key to improving the embattled Oracle Cerner rollout at the Department of Veterans Affairs. 

By Shira Fischer • Sept. 29, 2023

Judge greenlights LCMC Health’s $150M hospital buy

A district court judge on Wednesday ruled LCMC Health did not need to undergo federal review for its purchase of several HCA facilities.

By Susanna Vogel • Sept. 28, 2023

Ohio lawmakers propose minimum nurse-to-patient ratios

The state is the latest to propose “safe staffing” legislation in a push to address nurse recruitment and retention.

By Susanna Vogel • Sept. 27, 2023

MA premiums increase slightly for 2024

CVS, UnitedHealth and Humana expanded their MA footprints 13%, 4% and 2% respectively for next year, according to an analyst analysis of the CMS data.

By Rebecca Pifer Parduhn • Sept. 27, 2023

Elevance, BCBSLA pause $2.5B merger amid regulatory scrutiny

The health insurers originally expected their merger to close before the end of 2023, but have hit snags receiving the regulatory green light in Louisiana.

By Rebecca Pifer Parduhn • Sept. 26, 2023

FDA staff hold ‘major concerns’ with Brainstorm ALS therapy, documents show

Agency scientists flagged numerous issues with Brainstorm’s stem cell treatment ahead of a high-profile Wednesday meeting of expert FDA advisers.

By Ned Pagliarulo • Sept. 25, 2023

CMS to get ‘tougher’ on Medicare Advantage, official promises

Deputy Administrator Jon Blum signaled regulators could increasingly crack down on bad actors in the MA program, which now covers more than half of Medicare seniors.

By Rebecca Pifer Parduhn • Sept. 22, 2023

Federal agencies propose increase to No Surprises Act administrative fees

On Thursday, the HHS and other departments proposed a rule that would raise the independent dispute resolution process fees from $50 to $150. Last month, a federal court vacated a rate of $350.

By Susanna Vogel • Sept. 22, 2023

CMS requires 30 states to pause Medicaid disenrollments after systems error

Nearly 500,000 people will regain Medicaid or Children’s Health Insurance Program coverage after being improperly removed from the rolls during redeterminations, according to the HHS.

By Emily Olsen • Sept. 22, 2023

Biden administration seeks to erase medical debt from credit reports

In kicking off a medical debt rulemaking process, the Consumer Financial Protection Bureau aims to tackle what is a “serious pain point” for many families, Director Rohit Chopra said Thursday.

By Caitlin Mullen • Sept. 22, 2023

The one code Congress must support: G2211

Presidents of the American Academy of Family Physicians and the American College of Physicians argue for reforms in the national physician payment system.

By Tochi Iroku-Malize and Omar T. Atiq • Sept. 22, 2023

FTC sues US Anesthesia Partners, Welsh Carson over alleged price collusion in Texas

The PE firm and its anesthesia network rolled up multiple physician practices over the past decade, creating a dominant provider and charging Texans “tens of millions of dollars” more each year for anesthesia services, regulators allege.

By Rebecca Pifer Parduhn • Sept. 21, 2023

Frustration over surprise billing implementation builds in House hearing

Bipartisan lawmakers joined together to voice concerns about the implementation of the No Surprises Act, which critics say has created barriers to care.

By Susanna Vogel • Sept. 20, 2023

Home health advocates raise alarm over payment cuts, access to care

A new payment model and reimbursement cuts are straining home health agencies, but more data may be needed to fully evaluate the model, advocates and researchers said during a Senate finance committee hearing.

By Emily Olsen • Sept. 20, 2023

PBMs, PhRMA trade blame over drug costs in House hearing

Pharmacy benefit manager lobby PCMA and drugmaker lobby PhRMA pointed fingers over problems in the prescription supply chain during the House committee's second PBM hearing on Tuesday.

By Rebecca Pifer Parduhn • Sept. 19, 2023

Over 80% of nursing homes currently fall short of proposed CMS staffing thresholds

In over half of states, less than a quarter of nursing facilities would meet staffing requirements under a proposed federal rule, according to a new KFF analysis.

By Susanna Vogel • Sept. 19, 2023

New RSV vaccines can be powerful tools, but rollout poses test

Public health officials and drugmakers are trying to raise awareness of RSV among at-risk older adults — and convince them to get an additional respiratory shot alongside those for COVID-19 and flu.

By Delilah Alvarado • Sept. 18, 2023

Tennessee BCBS sued by former employees over COVID vaccine mandate

The new lawsuit alleges the nonprofit health plan violated employees' religious rights by not granting them an exemption to its inoculation requirement.

By Rebecca Pifer Parduhn • Sept. 18, 2023