Government: Page 63
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Biden pushes forward on Medicare price negotiation
But opposition from the drug industry and Republicans could make the Democrats' signature proposal an uphill battle.
By Jonathan Gardner • Sept. 13, 2021 -
Departing FDA officials, WHO leaders argue against broad rollout of COVID-19 booster shots
Marion Gruber and Philip Krause, two top FDA vaccine reviewers who are unexpectedly departing this fall, joined senior WHO officials in saying booster vaccine doses are not yet widely needed.
By Ned Pagliarulo • Sept. 13, 2021 -
HHS to release $25.5B in COVID-19 relief funding for providers
Some providers have been anxiously waiting on additional disbursements from the provider relief fund, especially for the period of the pandemic that saw the highest hospitalization rates.
By Samantha Liss • Sept. 13, 2021 -
Insurers to disclose relationships with brokers, agents in new CMS proposed rule
Other proposals would require air ambulances to disclose additional data to HHS and outline how CMS can enforce surprise billing protections if states fail to act.
By Rebecca Pifer Parduhn • Sept. 13, 2021 -
Retrieved from Shutterstock.
Sponsored by Consensus Cloud Solutions4 ways ADT event notifications improve payer performance
Our all-in-one real-time health event notification solution allows payers to work alongside providers to ensure that their members are on a path to better health outcomes that reduces waste and frustration.
By Bevey Miner, Health IT Strategy/CMO for Consensus • Sept. 13, 2021 -
Biden, industry groups mandate COVID-19 vaccines for most healthcare workers
CMS and the Centers for Disease Control and Prevention are requiring that all provider facilities that participate in the Medicare and Medicaid programs vaccinate their workers, according to a Thursday release.
By Ron Shinkman • Sept. 10, 2021 -
Surprise Billing
Industry pushes for more time before surprise billing ban enforced
Payers and hospitals say with the COVID-19 pandemic ongoing and key elements still unreleased, it will be difficult to comply by Jan. 1. Key sticking points include arbitration and qualified payment amounts.
By Shannon Muchmore • Sept. 9, 2021 -
Moderna expands mRNA vaccine supply in deal with new biotech producer
The company had previously said it could make up to 3 billion vaccine doses in 2022, depending on how booster shots are authorized.
By Shoshana Dubnow • Sept. 9, 2021 -
Biden admin shells out $452M to boost state reinsurance programs
The funding is aimed at getting more individuals to enroll in insurance at a lower cost, swelling coverage as the COVID-19 pandemic continues, HHS Secretary Xavier Becerra said.
By Rebecca Pifer Parduhn • Sept. 8, 2021 -
Feds sue UPMC, heart surgeon for billing multiple surgeries at same time
The False Claims Act litigation also accuses the health system of ignoring or minimizing complaints by employees and staff.
By Ron Shinkman • Sept. 7, 2021 -
Sponsored by Zelis
The low-down on the latest NSA Member ID and Advanced EOB Requirements
What you need to know about new NSA requirements for Member ID cards & AEOBs to reach compliance.
Sept. 7, 2021 -
AHA presents Congress with laundry list of requests for budget reconciliation bill
The hospital lobby asked that some of the funding be used to address the ongoing labor shortage, shore up mental health services and address ongoing coverage gaps.
By Ron Shinkman • Sept. 3, 2021 -
National Institute of Allergy and Infectious Diseases. (2020). "Novel Coronavirus SARS-CoV-2" [Micrograph]. Retrieved from Flickr.
Pfizer, Merck launch large new trials of oral COVID-19 drugs
Both companies are racing to prove their oral antivirals are effective as treatments for COVID-19. Key clinical results could come later this year.
By Kristin Jensen • Sept. 2, 2021 -
Medicare insolvency still expected by 2026, unchanged by COVID-19, trustees say
The forecast is a bit of a bright spot for the otherwise grim financial prospects of the program, as experts worried COVID-19 would result in the fund that finances Medicare Part A running out of money faster than previously expected.
By Rebecca Pifer Parduhn • Sept. 1, 2021 -
Hospital lobby urges Congress to extend Medicare cut relief
The cuts, if they go through, will result in an estimated loss of $36 billion in funding in 2022 alone, the Federation of American Hospitals said.
By Rebecca Pifer Parduhn • Sept. 1, 2021 -
Hospitals lose legal challenge over changes to DSH payments
A federal judge sided with HHS, pointing to a portion of the Medicare law that prohibits any administrative and judicial review of how the department arrived at its calculations.
By Samantha Liss • Sept. 1, 2021 -
Sutter to pay $90M in largest False Claims Act settlement against a health system for alleged MA fraud
The record payment comes on the heels of another massive settlement for the nonprofit, adding to the hit on its already stressed bottom line.
By Rebecca Pifer Parduhn • Aug. 31, 2021 -
FDA restarts distribution of Lilly's COVID-19 drug in 22 states
Use of the treatment had been halted due to weakened efficacy versus an early coronavirus variant. Now, with delta widely prevalent and demand for antibody treatments surging, Lilly's therapy will be available again.
By Shoshana Dubnow • Aug. 31, 2021 -
Carol Highsmith. (2005). "Apex Bldg." [Photo]. Retrieved from Wikimedia Commons.
New Jersey hospitals appeal FTC merger challenge
Hackensack Meridian Health, the largest health system in New Jersey, wants to to acquire a close competitor. The Federal Trade Commission won an injunction to stop the deal, which is now headed to an appeals court.
By Samantha Liss • Aug. 30, 2021 -
Philips sleep apnea, ventilator recall triggers US lawmaker scrutiny, legal woes
Patients seeking class-action status and Sen. Richard Blumenthal are questioning the medtech's timing of the recall and outreach to patients. Philips has not quantified the impact of the suits but said it could be material.
By Nick Paul Taylor • Updated Aug. 28, 2021 -
North Carolina amends certificate of need in bill headed to governor's desk
The laws came under scrutiny as the COVID-19 pandemic gripped the nation last year and overwhelmed hospital resources, raising questions about the value of the restrictions.
By Samantha Liss • Aug. 26, 2021 -
J&J, without details, makes case for a coronavirus booster shot
A second shot given six months after the first appears to provide a bigger immune response, the company said, a finding J&J aims to take to regulators in the U.S. and elsewhere.
By Ben Fidler • Aug. 25, 2021 -
Medicaid, ACA policies for COVID-19 kept rate of uninsured steady, researchers find
The uninsured rate remained at 11% from March 2019 to April 2021, thanks to a freeze in Medicaid disenrollment and increased ACA subsidies, according to a report from the Urban Institute.
By Hailey Mensik • Aug. 24, 2021 -
FDA grants full approval to Pfizer, BioNTech's coronavirus vaccine
The long-awaited decision could strengthen the case for vaccine mandates as public health officials seek to boost rates of immunization amid a wave of COVID-19 cases.
By Jonathan Gardner • Updated Aug. 23, 2021 -
Biden said to rule out Woodcock as permanent FDA chief
A news report indicated the agency's longtime drug reviewer is no longer in consideration for the role, leaving the FDA's top job in flux as key decisions near on coronavirus booster shots and vaccinations for children.
By Jonathan Gardner • Aug. 20, 2021