Hospital lobby argues its case against 340B payment cut before SCOTUS

Tuesday's arguments seemed to center around single words and phrases to determine whether HHS had the authority to change payment rules in 2018 for 340B hospitals, which serve a large share of low-income patients.

By Samantha Liss • Dec. 1, 2021

Hospital lobbying fails to stop looming Medicare cuts in year-end proposal

Lawmakers on Thursday reached a bipartisan year-end spending bill that doesn't include provisions to push back or stop the upcoming Medicare cuts.

By Rebecca Pifer Parduhn • Updated Dec. 3, 2021

Supreme Court to hear oral arguments in 340B case with billions of dollars at stake

A lower court initially sided with the American Hospital Association, a decision that was later reversed by an appeals court, which AHA characterized as a "legal error."

By Samantha Liss • Nov. 30, 2021

Healthcare worker vaccine mandate blocked nationwide in second ruling

A federal judge granted a preliminary injunction Tuesday in a suit brought by 14 states challenging the requirement, following separate pauses in other states.

By Hailey Mensik • Updated Dec. 1, 2021

Biden admin investing $1.5B to quell healthcare staffing shortages, promote workforce equity

The funding will go toward scholarship and loan repayment programs for healthcare students committing to work in hard-hit and high-risk communities, according to the White House.

By Hailey Mensik • Nov. 23, 2021

Anesthesiologists say Blue Cross NC 'abusing' surprise billing ban to drive down rates

Doctors are raising the alarm against what they perceive as Blue Cross NC's "take it or leave it" ultimatums to in-network clinicians, using the consumer protection legislation as a bargaining chip to negotiate more favorable rates.

By Rebecca Pifer Parduhn • Nov. 23, 2021

Ground ambulances, excluded from surprise billing ban, to get scrutiny from federal committee

Recommendations from the new federal advisory committee will help inform policy changes to improve how charges and fees for ground ambulance services are disclosed to consumers, CMS said.

By Hailey Mensik • Nov. 22, 2021

FDA, aiming to curb another COVID-19 surge, clears Pfizer, Moderna boosters for all adults

The decision comes as at least 10 states open up booster dose eligibility beyond the current, more limited authorizations while cases remain at high levels.

By Ben Fidler • Nov. 19, 2021

Biden admin proposes wide-reaching drug data collection in fourth surprise billing rule

Payers and employers will need to give HHS an annual overview of the top 50 drugs across different areas, including the most frequently dispensed drugs and the most expensive prescription drugs.

By Rebecca Pifer Parduhn • Nov. 18, 2021

MCIT breakthrough device payment pathway included in Cures 2.0 bill

Lawmakers on Tuesday introduced a revised MCIT proposal in the next version of the 21st Century Cures Act, following last week's repeal of the final rule by CMS. Industry groups AdvaMed and MDMA backed the legislation.

By Nick Paul Taylor • Nov. 18, 2021

30% of hospital healthcare workers remained unvaccinated as of September

Healthcare workers in children's hospitals had the highest vaccination rates, along with those working in metropolitan counties, according to the analysis of Centers for Disease Control and Prevention data.

By Hailey Mensik • Nov. 18, 2021

Pfizer asks FDA to authorize COVID-19 pill

Study results released earlier this month showed the pill, when given soon after symptoms start, dramatically reduced the risk of COVID-19 hospitalization or death.

By Ned Pagliarulo • Nov. 17, 2021

Congress, alongside provider and consumer groups, continues spat over surprise billing ban rules

While payers and providers must start complying with the No Surprises Act by Jan. 1, the fight over rules implementing the ban is heating up as provider groups object to what they think is a favoring of insurers.

By Hailey Mensik • Nov. 17, 2021

CMS guides hospitals on co-location of staff, services

The agency's final guidance on the practice of sharing resources in an effort to improve provider efficiency drew praise from the American Hospital Association.

By Susan Kelly • Nov. 17, 2021

As Congress weighs drug price restraints, ICER calls out 'unsupported' increases

In a new report, ICER highlighted AbbVie's price hikes on Humira, which the group said resulted in more than $1 billion in U.S. spending last year without any new evidence of health benefits.

By Jonathan Gardner • Nov. 16, 2021

Congress: Target the middlemen who drive up drug costs

"The PBM market lacks the three elements essential for competition — choice, transparency and a lack of conflict of interest," antitrust attorney and former FTC policy director David Balto argues.

By David Balto • Nov. 15, 2021

Biogen's pricey Alzheimer's drug contributes to major Medicare premium hikes

The 15% jump in Part B premiums for 2022 is a case study in how just one expensive medication can affect the spending of millions in the U.S.

By Rebecca Pifer Parduhn • Nov. 15, 2021

Zelis helps address new NSA and TiC regulations

Learn more about innovative solutions that can help you comply with new regulations.

Nov. 15, 2021

Moderna, escalating dispute with NIH, claims government had no role in key vaccine patent

The biotech claimed its NIH partners were involved only after a key discovery was made "by Moderna scientists using Moderna technology." The dispute over who invented a critical part of the vaccine could end up in court.

By Jonathan Gardner , Ben Fidler • Nov. 12, 2021

Biden nominates Robert Califf to return to as head of FDA

If confirmed by Congress, the cardiologist would return to lead an agency taxed by a heavy workload reviewing COVID-19 drugs and vaccines.

By Ned Pagliarulo , Jonathan Gardner • Updated Nov. 12, 2021

Pfizer again asks FDA to authorize COVID-19 boosters for all adults

Agency advisers had opposed a broad booster dose clearance in September, leading the FDA to limit use to older adults and those at high risk of COVID-19.

By Jonathan Gardner • Nov. 10, 2021

Health centers raise alarm about rolling back Medicaid coverage post-public health emergency

The clinics are worried about people with Medicaid coverage being deemed ineligible and losing insurance once states revert back to pre-pandemic Medicaid policies and eligibility, a new survey found.

By Rebecca Pifer Parduhn • Nov. 10, 2021

Pfizer pill for COVID-19 shows dramatic benefit in major study finding

The drugmaker, which last week won FDA clearance of its vaccine in younger children, plans to quickly ask the agency for emergency authorization of the drug in high-risk patients.

By Jonathan Gardner • Nov. 5, 2021

Democrats' drug pricing plan, while scaled back, could still squeeze pharma top-sellers

Legislation backed by President Joe Biden and top Democratic lawmakers would allow for price negotiation on up to 20 older drugs, potentially impacting blockbusters from Pfizer, Bristol Myers Squibb and others.

By Jonathan Gardner • Nov. 5, 2021

Adults support major changes to US healthcare system amid rising costs, survey finds

Those surveyed showed the widest support for policy changes that could lower drug costs, followed by measures limiting what both hospitals and doctors can charge for services, according to the Robert Wood Johnson Foundation.

By Hailey Mensik • Nov. 4, 2021