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 Parduhn • 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

Biden’s proposed HHS budget aims to make pandemic-era subsidies permanent

The budget also proposes to extend Medicare solvency and give the federal government more power to negotiate prescription drug prices.

By Sydney Halleman • March 9, 2023

California cancels $54M Walgreens contract over company’s decision to not sell abortion pills

California Gov. Gavin Newsom is making good on his threat to no longer do business with Walgreens over abortion pill access, illustrating how the drugstore industry is struggling to navigate shifting state abortion laws.

By Rebecca Pifer Parduhn • March 9, 2023

House committee latest to launch investigation into PBMs

It’s the most recent action targeting PBMs for allegedly using their market power to raise drug prices, and comes as the Federal Trade Commission also launched a similar investigation.

By Hailey Mensik • March 8, 2023

Texas women, denied medically necessary abortions, sue state to clarify exceptions to ban

The lawsuit highlights how abortion bans create a chilling effect for obstetric care, as physicians — worried about legal repercussions — can refuse or delay care to those with complications.

By Rebecca Pifer Parduhn • March 8, 2023

Insurers, trade groups ask CMS to delay MA rule

Insurance lobbyists argue that the 1.03% plan increase is insufficient and, in combination with other changes, would actually result in payment cuts.

By Sydney Halleman • March 7, 2023

FTC pushes back deadline for public to weigh in on noncompete ban

FTC Commissioner Christine Wilson said she would have supported an even longer extension since the proposed rule is “a departure from hundreds of years of precedent.” 

By Samantha Liss • March 7, 2023

Biden’s plan to improve Medicare solvency targets prescription drugs

The plan — part of Biden’s 2024 budget proposal set to be released Thursday — would further reduce what Medicare pays for prescription drugs and raise taxes on Americans earning over $400,000.

By Rebecca Pifer Parduhn • March 7, 2023

Healthcare cybersecurity still has room to improve safety

Steve Winterfeld, Akamai's advisory chief information and security officer, outlines the threat of cyberattacks to healthcare organizations and what the industry can do to prevent them.

By Steve Winterfeld • March 3, 2023

FTC bans BetterHelp from sharing consumer data with advertisers, issues $7.8M fine

It’s the latest enforcement action accusing a digital health company of sharing consumer data with advertisers.

By Rebecca Pifer Parduhn • March 2, 2023

Gross margins in MA market returned to pre-pandemic levels by end of 2021, report finds

The analysis of insurer markets in 2021, the latest year of available annual data, sheds light into the varied financial performance of insurers during the COVID-19 pandemic.

By Sydney Halleman • March 1, 2023

Lilly to lower insulin prices by 70%

The pharma company has long been under pressure over the high cost of insulin — scrutiny that has recently ramped up in the U.S.

By Jonathan Gardner • March 1, 2023

Why regulators didn’t challenge Amazon-One Medical deal, despite data concerns

The ecommerce giant's $3.9 billion buy of primary care company One Medical closed without a challenge from the FTC, even as consumer protection groups and regulators aired worries about the tie-up.

By Rebecca Pifer Parduhn • March 1, 2023

UPMC, top surgeon pay $8.5M to settle whistleblower lawsuit over simultaneous surgeries

The lawsuit alleges that UPMC’s longtime head of cardiothoracic surgery, James Luketich, regularly performed as many as three complex surgeries at the same time.

By Rebecca Pifer Parduhn • Feb. 28, 2023

Illinois nurses file class action lawsuit against Ascension over wage issues

The lawsuit, filed on behalf of four current and former Illinois nurses, alleges that Ascension failed to properly pay employees and that the health system engaged in “improper” cost-cutting practices.

By Sydney Halleman • Feb. 27, 2023

CMS says surprise billing arbitration can resume for some disputes — others remain on pause

Regulators are continuing to work on new guidance in light of a court decision that ruled against the government and threw a wrench in the third-party process to resolve payment disputes between payers and providers.

By Samantha Liss • Feb. 27, 2023

FDA authorizes first at-home flu-COVID-19 combination test days after its developer files for bankruptcy

Lucira filed for bankruptcy protection last week, saying the “protracted” authorization process caused it to miss out on test sales in the latest flu season.

By Nick Paul Taylor • Feb. 27, 2023

Partisan gridlock shouldn’t threaten true value in healthcare

Oak Street CEO Mike Pykosz makes the case for value-based healthcare policy despite potential partisan gridlock in the 118th Congress.

By Mike Pykosz • Feb. 24, 2023

Hospital lobby opposes noncompete ban, says ‘now is not the time to upend’ labor markets

The American Hospital Association is pushing the FTC to abandon its proposal to eliminate restrictive covenants. At the very least, the lobby wants physicians and senior executives exempt.

By Samantha Liss • Feb. 24, 2023

Amazon closes $3.9B buy of One Medical

The acquisition, which closed without a challenge from regulators, gives Amazon a footprint in primary care and reinvigorates the company’s long-held plans to sell healthcare services to employers.

By Rebecca Pifer Parduhn • Feb. 22, 2023

HIPAA complaints, breaches increased from 2017 to 2021 as HHS urges more funding

The HHS Office for Civil Rights is facing a “severe strain” on its staff and budget amid rising breaches and complaints, according to the agency’s annual report to Congress.

By Rebecca Pifer Parduhn • Feb. 21, 2023

Medicaid enrollees largely unaware of upcoming redeterminations, survey finds

About 64% of adults in a Medicaid-enrolled family said they didn’t know they could lose coverage once eligibility checks resume on April 1, a survey from the Robert Wood Johnson Foundation found.

By Hailey Mensik • Feb. 21, 2023

Could Medicaid redeterminations cause short-term health plan signups to spike?

Short-term plan operators will likely ramp up their marketing in April to nab new consumers from the Medicaid churn, but health policy experts largely aren't concerned.

By Rebecca Pifer Parduhn • Feb. 21, 2023