Government: Page 48
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Surprise BillingThe portal to resolve surprise bills has been inundated with disputes — SCP Health tops the list
Federal agencies received more disputes in a five-month window than they expected to receive in a full year.
By Samantha Liss • Updated Jan. 9, 2023 -
Illustration: Xavier Lalanne-Tauzia for Industry Dive
Deep DiveThe Advocate-Atrium merger closed without an antitrust challenge. What does that mean for competition in 2023?
Health systems have morphed into multi-regional players through acquisitions, but have evaded federal antitrust enforcement, raising questions about the future of policing merger deals.
By Samantha Liss • Dec. 22, 2022 -
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Stakes are high in California’s Medicaid market shakeup
Four insurers that lost out on lucrative contracts in the state’s first-ever competitive process are challenging the state's picks.
By Susan Kelly • Dec. 21, 2022 -
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Surprise BillingJudge questions surprise billing ban implementation during court hearing
A federal judge on Tuesday tested the government’s defense concerning a rule designed to help third parties resolve payment disputes between providers and insurers.
By Samantha Liss • Dec. 21, 2022 -
Megan Quinn/Healthcare Dive
‘Bravo Congress’: Telehealth groups cheer omnibus extension of COVID-19 flexibilities
Still, the American Telemedicine Association and other virtual care lobbies said there was more to do to enshrine telehealth access into American law.
By Rebecca Pifer Parduhn • Dec. 21, 2022 -
Asher Heimermann. Retrieved from Wikimedia Commons.
HHS releases ownership data on nation’s hospitals
“We are pulling back the curtain and letting the sunshine in on hospital and nursing home ownership because it is what the public deserves,” HHS Secretary Xavier Becerra said Tuesday in a statement.
By Samantha Liss • Dec. 21, 2022 -
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Omnibus bill restarts Medicaid checks, lowers Medicare physician pay cuts
President Joe Biden signed the the $1.7 trillion omnibus spending package into law on Dec. 29.
By Sydney Halleman • Updated Jan. 3, 2023 -
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Government watchdog warns of Medicare fraud after relaxing provider requirements
The Government Accountability Office is urging the CMS to resume certain eligibility checks on providers whom they consider at high risk of fraud to the Medicare program.
By Samantha Liss • Dec. 20, 2022 -
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CMS rule aimed at improving Medicare Advantage draws praise
Proposed changes target prior authorization holdups and misleading advertising while aiming to expand access to behavioral health care and affordable prescriptions.
By Susan Kelly • Dec. 19, 2022 -
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Scan Group, CareOregon to merge, forming $6.8B health plan
Together the two will serve nearly 800,000 Medicaid and Medicare members across five states, giving them greater scale to take on competitors.
By Samantha Liss • Dec. 15, 2022 -
National health spending reached $4.3 trillion in 2021
Increases in healthcare utilization and insurance coverage were offset by lower government spending on COVID-19, according to new CMS data.
By Rebecca Pifer Parduhn • Dec. 14, 2022 -
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CMS estimates 41.5M people affected by innovation center models since late 2020
The Center for Medicare and Medicaid Innovation is currently operating 33 models studying potential improvements in healthcare payment and delivery.
By Rebecca Pifer Parduhn • Dec. 14, 2022 -
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Maternal health services suffer in states with abortion bans, report finds
States risk driving away healthcare providers who are reluctant to work where their practices will be restricted, according to a Commonwealth Fund analysis.
By Susan Kelly • Dec. 14, 2022 -
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CMS tackles provider availability, exchange regulations in proposed rule
The regulation comes after the ACA exchanges, spurred by financial incentives during the COVID-19 pandemic, reached record enrollment numbers.
By Sydney Halleman • Dec. 13, 2022 -
Courtesy of Foster Farms
COVID-19 vaccine saved millions of lives, study calculates
The vaccines also reduced infections and hospitalizations, which freed up hospital resources, researchers at the Commonwealth Fund and Yale School of Public Health concluded.
By Susan Kelly • Dec. 13, 2022 -
Variability in Medicare direct contracting savings illustrates promises, pitfalls of value-based care
Accountable care organizations' net savings rates ranged from -29.4% to 29.2% in the 2021 Global and Professional Direct Contracting Model.
By Rebecca Pifer Parduhn • Updated Dec. 13, 2022 -
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Progressive lawmakers call on CMS to cull companies with history of Medicare fraud from ACO REACH
At least 10 organizations with records of healthcare fraud and abuse participated in the direct contracting program last year despite CMS screening requirements, the letter said.
By Rebecca Pifer Parduhn • Updated Dec. 20, 2022 -
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OSHA moves ahead with permanent COVID-19 standards for health workers
The submission for permanent COVID-19 safety standards comes after temporary pandemic requirements for medical facilities were withdrawn last December.
By Hailey Mensik • Dec. 9, 2022 -
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Payers, providers applaud new CMS prior authorization rule
Provider groups, including the AHA, asked the Senate to codify measures proposed by the CMS by passing bipartisan legislation imposing more prior authorization requirements on Medicare Advantage plans.
By Rebecca Pifer Parduhn • Dec. 8, 2022 -
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AdvaMed asks FDA to withdraw divisive draft guidance on LASIK surgery
Some comments were more positive, though, with the American Optometric Association calling the agency’s proposal “timely and beneficial.”
By Nick Paul Taylor • Dec. 8, 2022 -
Patient discharge delays pose threat to health outcomes, AHA warns
The hospital lobby is asking Congress to establish a temporary per diem Medicare payment to help ease healthcare capacity issues.
By Susan Kelly • Dec. 7, 2022 -
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Medicaid redeterminations18M projected to lose Medicaid coverage at end of COVID-19 emergency
Many people who are currently enrolled in Medicaid will transition to other coverage, but 3.8 million people will completely lose insurance, according to the Robert Wood Johnson Foundation.
By Susan Kelly • Dec. 6, 2022 -
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HHS to lift mpox emergency declaration as cases drop
New reported daily cases of the virus in the U.S. have dwindled to under 10 from more than 600 per day in August.
By Susan Kelly • Dec. 6, 2022 -
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Key healthcare stories from 2022
This year has been especially tumultuous for healthcare, with the overturning of Roe v. Wade, numerous labor disputes and major M&A announcements.
By Shannon Muchmore • Dec. 5, 2022 -
Courtesy of Advocate Aurora Health, Atrium Health
Advocate Aurora and Atrium complete merger, creating $27B system
The new system, Advocate Health, will operate 67 hospitals and more than 1,000 sites of care in six states.
By Samantha Liss • Dec. 2, 2022
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