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    Sponsored by Teleperformance

    Implementing high-tech, high-touch digital services to create more personalized, patient-centric care

    Improve the patient experience by addressing high interaction volume and channel complexity.

    By Jeff Hechemy, Executive Vice President – Healthcare at Teleperformance • Jan. 22, 2024
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    CMS finalizes rule tightening prior authorization turnaround for insurers

    Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones — that should cut back coverage determination limbo for patients.

    By • Jan. 17, 2024
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    Surprise 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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    MA spending to outstrip traditional Medicare by $88B this year: MedPAC

    MedPAC released the data Friday during a contentious meeting where members argued over the efficacy of Medicare Advantage.

    By • Jan. 16, 2024
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    HCA granted extension to respond to Mission lawsuit

    The for-profit is being sued for allegedly cutting back medical care at Mission Hospital since purchasing the North Carolina facility in 2019. 

    By Susanna Vogel • Jan. 12, 2024
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    ACA enrollment for 2024 reaches record high

    More than 20 million Americans have signed up for Affordable Care Act plans since open enrollment began in November. Sign-ups are expected to continue to grow.

    By • Jan. 11, 2024
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    FTC bars data broker from selling sensitive location information, like clinic visits

    The Federal Trade Commission reached a first-of-its-kind settlement with a data broker that the regulator alleged sold data that could be used to track visits to medical or reproductive health clinics.

    By Emily Olsen • Jan. 10, 2024
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    HHS publishes updated provider conscience rule, rolls back Trump-era policy

    The department framed the rule as a “balance” that safeguards providers’ rights to religious freedom and patients’ access to care.

    By Susanna Vogel • Jan. 10, 2024
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    Providers push back on info blocking penalties

    Provider groups argued for changes in financial penalties and more information on an appeals process. 

    By Emily Olsen • Jan. 8, 2024
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    HHS names first chief competition officer

    Stacy Sanders will work with regulators to tackle industry consolidation in an effort to rein in rising healthcare costs.

    By Emily Olsen • Jan. 8, 2024
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    Elevance sues HHS over Medicare Advantage star ratings

    The payer is taking issue with how regulators calculated quality scores for 2024, after seeing a stars decline that could cause its bonus revenue to fall by $500 million.

    By • Jan. 8, 2024
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    FDA authorizes Florida to import drugs from Canada

    The clearance is a major shift for the agency, which described its decision as a “first step” in allowing Florida to bulk purchase lower-cost Canadian medicines. 

    By Jonathan Gardner , Ned Pagliarulo • Jan. 5, 2024
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    More hospitals, payers compliant with price transparency laws

    More than 90% of hospitals posted files at least partially compliant with price transparency requirements in 2023, according to a new report from Turquoise Health.

    By Susanna Vogel • Jan. 5, 2024
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    Antitrust enforcements hit a high in 2022, with health deals impacted

    The 2022 report comes after regulators finalized merger guidelines this week that could have a chilling effect on healthcare M&A.

    By Susanna Vogel • Dec. 22, 2023
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    Over 19M could enroll in ACA plans for 2024, CMS says

    Enrollment in the Affordable Care Act exchanges could be boosted by extended subsidies and the effects of Medicaid redeterminations.

    By Emily Olsen • Dec. 21, 2023
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    Shared Savings Program linked to net losses in traditional Medicare, study finds

    However, the program was associated with savings in Medicare Advantage and for the CMS overall.

    By Emily Olsen • Dec. 20, 2023
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    Steward Health Care hit with False Claims Act lawsuit

    The suit alleges a Steward-run hospital improperly billed Medicare for more than 1,000 false claims.

    By Susanna Vogel • Dec. 20, 2023
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    FTC, DOJ finalize merger guidelines that could impede healthcare M&A

    The new guidelines should give regulators sharper teeth in going after vertical and cross-market deals that have historically been difficult to challenge.

    By • Dec. 19, 2023
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    Medicaid redeterminations

    Biden administration urges 9 states to curb high child Medicaid, CHIP disenrollments

    Nine states account for about 60% of the decline in children’s Medicaid and Children’s Health Insurance Program enrollment from March through September, according to data from the CMS.

    By Emily Olsen • Dec. 19, 2023
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    John Muir, Tenet hospital deal collapses following FTC lawsuit

    John Muir Health will no longer acquire a California medical center from Tenet Healthcare, one month after regulators sued to block the deal over concerns it could drive up health costs in the region.

    By • Dec. 19, 2023
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    Surprise Billing

    No Surprises Act dispute portal reopens again amid ‘challenging’ policy rollout

    The CMS has repeatedly stopped and restarted arbitration this year as court cases snarl regulatory efforts to resolve surprise billing disputes.

    By Susanna Vogel • Dec. 18, 2023
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    Lawsuit alleges New Jersey’s telehealth licensure rules hamper access to care

    The suit comes as relaxed pandemic-era licensure rules for virtual care expire. Standard regulations are onerous for patients who may not be able to access specialty care for rare conditions, the lawsuit said. 

    By Emily Olsen • Dec. 18, 2023
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    CVS, Geisinger, others sign responsible AI in healthcare pledge

    The voluntary commitment from 28 healthcare organizations comes as interest in artificial intelligence continues to grow.

    By Emily Olsen • Dec. 15, 2023
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    North Carolina AG sues HCA over degraded care quality at Mission Health

    Attorney General Josh Stein slammed staffing and service shortages at Mission Hospital after HCA acquired it in 2019. “Responsibility for this downward spiral rests entirely with HCA,” the lawsuit says.

    By Susanna Vogel • Dec. 15, 2023
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    CMS asks health plans, PBMs to ease up on independent pharmacies

    A new letter urges payers to put in place special payment arrangements with pharmacies before a new policy kicks in that could reduce how much pharmacies are paid upfront.

    By • Dec. 15, 2023
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    Health spending growth normalized in 2022 post-COVID, CMS says

    Healthcare spending grew 4.1% in 2022, faster than 2021’s growth but notably slower than 2020’s, according to government actuaries.

    By • Dec. 14, 2023