Government: Page 46
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Courtesy of Eli Lilly
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 -
Edward Smith via Getty Images
Deep DiveWhy 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 -
Screenshot: Google Maps
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 -
Surprise Billing
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 -
Courtesy of U.S. Food and Drug Administration
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 -
Adeline Kon/Healthcare Dive
OpinionPartisan 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 -
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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 -
David Ryder / Stringer via Getty Images
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 -
Getty Images
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 redeterminations
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 -
Deep Dive // Medicaid redeterminations
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 -
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SUNY Upstate, Crouse Health System call off merger
The Federal Trade Commission, which opposed the tie-up, cheered the news on Thursday. Previously, the agency had warned state lawmakers about the dangers of shielding hospital mergers from antitrust enforcement.
By Samantha Liss • Feb. 17, 2023 -
Stefani Reynolds / Stringer via Getty Images
Lawmakers stress urgency of healthcare worker shortage
Addressing the education pipeline is one issue legislators can focus on to improve nurse and physician shortages, medical school and health system leaders said during a Senate committee hearing.
By Hailey Mensik • Feb. 16, 2023 -
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Boston Scientific, MDMA call for more transparency, oversight of Medicare Advantage plans
Privately offered Medicare Advantage plans “do not often provide a clear reason for the denial of coverage, and rarely offer any visibility into the evidence and methodology,” trade group MDMA and Boston Scientific said.
By Nick Paul Taylor • Feb. 15, 2023 -
Alex Wong via Getty Images
CMS plans trio of experiments aimed at lowering drug costs
The pilot programs could allow adjusted payments for drugs cleared under accelerated approval and help states manage the costs of gene therapies.
By Christopher Newman • Feb. 15, 2023 -
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Senator blasts Ascension, alleging it runs like private equity fund rather than nonprofit health system
Sen. Tammy Baldwin, D-Wis., said the system “appears to be evaluating each staffing decision, service line, and hospital location as solely a business decision while seeking to bolster cash to put towards its investment funds.”
By Hailey Mensik • Feb. 15, 2023 -
Surgical procedures cost significantly more at hospitals in networks versus independent facilities, study finds
The median price for a shoulder arthroscopy was $4,432 at hospitals within a network, compared to $2,643 at independent hospitals, new research in JAMA Network Open found.
By Hailey Mensik • Feb. 14, 2023 -
Courtesy of HHS
ONC debuts first cohort of qualified networks in TEFCA, including Epic, eHealth Exchange
Epic, CommonWell Health Alliance, eHealth Exchange, Health Gorilla, Kno2 and Konza — which collectively cover a significant swath of American health records — have committed to go live within TEFCA in 12 months.
By Rebecca Pifer Parduhn • Feb. 14, 2023 -
Carol Highsmith. (2005). "The Apex Building" [Photo]. Retrieved from Wikimedia Commons.
Deep DiveFTC’s enforcement action against GoodRx unveiled a new regulatory threat. Should digital health apps be concerned?
The order suggests the regulator is willing to use every tool in its tookit to tamp down on sensitive data sharing as medical care turns increasingly online.
By Rebecca Pifer Parduhn • Feb. 13, 2023 -
Surprise Billing
HHS pauses surprise billing arbitration after Texas court decision
The process by which health insurers and medical providers hash out payments for surprise bills is still in flux due to a series of lawsuits threatening the dispute resolution process.
By Rebecca Pifer Parduhn • Feb. 13, 2023 -
Mark Wilson via Getty Images
Medicare to collect drug price rebates starting in 2025
The CMS has laid out how it plans to implement a key provision of the Inflation Reduction Act requiring drugmakers to pay rebates on price hikes in Medicare that are greater than inflation.
By Christopher Newman • Feb. 10, 2023 -
Drew Angerer / Staff via Getty Images
HHS readies for PHE wind down, end of pandemic flexibilities
A variety of pandemic-era policies will expire May 11, including those allowing providers to prescribe controlled substances via telehealth without an in-person visit and rules requiring payers to cover COVID-19 testing.
By Hailey Mensik • Feb. 10, 2023 -
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Biden zeroes in on drug costs during State of the Union address
The president called for extending Medicare's $35 insulin price cap to all Americans and blasted “big pharma” for record profits while at the same time “unfairly charging people hundreds of dollars.”
By Shannon Muchmore • Feb. 8, 2023 -
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MA enrollment grew 337% from 2006 through 2022, study finds
Traditional Medicare lost 1 million enrollees over the same period, according to new research published in Health Affairs.
By Hailey Mensik • Feb. 7, 2023
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