Government: Page 46
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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 Parduhn • June 15, 2023 -
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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 -
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TrendlineSurprise 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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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 -
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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 -
Photogeek, Photo by Drazen
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 -
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Medicaid redeterminationsHHS 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 -
Rebecca Pifer/Healthcare Dive
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 Parduhn • June 9, 2023 -
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OpinionThe 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 -
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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 -
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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 -
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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 -
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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 -
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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 -
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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 Parduhn • June 5, 2023 -
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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 -
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Medicaid redeterminationsOver 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 -
Courtesy of Eisai
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 -
Photo by Sarah Chai from Pexels
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 -
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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 Parduhn • May 30, 2023 -
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CVS could lose up to $1B next year from MA star ratings drop
Just 21% of CVS’ MA members are currently in plans with a star rating of at least four, down from 87% at the end of 2021, the payer disclosed.
By Rebecca Pifer Parduhn • May 26, 2023 -
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Medicaid redeterminationsTwo-thirds of Medicaid enrollees unaware of redeterminations, survey finds
The KFF survey found many enrollees weren’t sure whether states are now allowed to remove people from the program, and 27% wouldn’t know where to look for coverage if they were ineligible for Medicaid.
By Emily Olsen • May 25, 2023 -
Bill Clark/CQ Roll Call/Newscom
AHIP chief executive to step down in October
Matt Eyles will depart after serving nearly five years as CEO of AHIP. The organization is launching a nationwide search for his replacement.
By Sydney Halleman • May 25, 2023 -
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US projected to hit record-low uninsurance rate this year
But as federal aid expires, lower-income Americans — who saw the largest insurance gains during the pandemic — will likely be affected the most, according to experts.
By Rebecca Pifer Parduhn • May 24, 2023 -
Biden administration aims to increase Medicaid drug transparency
The notice of proposed rulemaking recommends that the CMS and states get a drug price verification survey tool and negotiate for expensive drugs under Medicaid.
By Brian T. Horowitz • May 24, 2023 -
Rebecca Pifer/Healthcare Dive
House lawmakers, PBM lobby spar over committee hearing
At the latest congressional inquiry into pharmacy benefit managers, lawmakers argued the middlemen profit at the expense of patients and taxpayers.
By Rebecca Pifer Parduhn • May 24, 2023
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