Government: Page 65
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CDC recommends Pfizer booster shots for many, overruling advisers on broad use
Though an agency panel voted against advising a third Pfizer vaccine dose for younger people in high-risk jobs like nursing or teaching, it was overriden by CDC Director Rochelle Walensky.
By Shoshana Dubnow , Ned Pagliarulo • Updated Sept. 24, 2021 -
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State Medicaid officials face daunting fall season amid low vaccination rates, record enrollment
Telehealth and behavioral health service needs are also a challenge as the COVID-19 pandemic drags on and the Biden administration encourages more people to get on the rolls.
By Hailey Mensik • Sept. 23, 2021 -
OIG flags potential $5B overpaid to Medicare Advantage plans
The watchdog calls out 20 private insurers, which it does not name, and urges CMS to conduct greater oversight.
By Samantha Liss • Sept. 22, 2021 -
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Second dose of J&J's coronavirus vaccine increases protection, company says
Long-awaited results from a Phase 3 study run by J&J could support use of a booster dose, although the drugmaker has not officially applied for FDA clearance yet.
By Shoshana Dubnow • Sept. 21, 2021 -
Antonio Masiello via Getty Images
Pfizer says coronavirus vaccine is safe, spurs immune response in children
The results position Pfizer and BioNTech to seek clearance in children as young as 5 years old. But the companies haven't yet shared data on a rare heart inflammation associated with their shot that's a concern for regulators.
By Jonathan Gardner • Sept. 21, 2021 -
Jens Schlueter via Getty Images
FDA advisers support booster dose of Pfizer vaccine in older or high-risk adults
In a back-and-forth meeting Friday, the committee opposed clearing a third shot widely for use in people older than 16, but agreed the benefits outweighed the risks for adults over 65 or those at risk of severe COVID-19.
By Shoshana Dubnow , Ned Pagliarulo • Updated Sept. 17, 2021 -
Permission granted by University of Maryland School of Medicine
New data from Israel, Pfizer show potent effect from third coronavirus shot
The much-anticipated data arrived two days before an important FDA advisory meeting to discuss authorization of a booster dose for Pfizer's coronavirus vaccine.
By Jonathan Gardner • Sept. 16, 2021 -
Carol Highsmith. (2005). "Apex Bldg." [Photo]. Retrieved from Wikimedia Commons.
FTC warns app makers fall under breach notification rule
The agency noted that a breach must be reported regardless of whether it was the result of malicious action. Any unauthorized access, including sharing information without consent, would trigger the rule.
By Shannon Muchmore • Sept. 16, 2021 -
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FDA staff tight-lipped on booster shot views ahead of consequential meeting
In a briefing document released Wednesday, agency reviewers did not make a strong case either for or against the broad authorization of boosters for the general public.
By Shoshana Dubnow • Sept. 16, 2021 -
Providers balk at MIPS value program, Medicare rate in physician pay rule comments
While providers strongly support the telehealth coverage increases in the proposed rule, they asked the agency to go further by putting the services that are now going to be covered through the end of 2023 on the permanent list.
By Shannon Muchmore • Sept. 15, 2021 -
In rare move, DOJ intervenes in MA fraud case against data mining company
Defendants Independent Health, an MA payer, and its now defunct medical analytics subsidiary DxID denied all allegations of wrongdoing and said they planned to defend themselves "vigorously" in court.
By Rebecca Pifer Parduhn • Sept. 15, 2021 -
Alex Wong via Getty Images
CMS moves to scrap Medicare coverage of breakthrough devices due to clinical evidence concerns
AdvaMed said the repeal of the Medicare Coverage of Innovative Technology rule is the wrong decision for patients. Analysts noted the reimbursement pathway could be resurrected in Cures 2.0 legislation.
By Nick Paul Taylor • Sept. 14, 2021 -
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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 -
Mario Tama via Getty Images
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 -
Mario Tama via Getty Images
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 -
Jens Schlueter via Getty Images
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 -
Courtesy of National Resilience; Business Wire
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 -
Alex Wong via Getty Images
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 -
Permission granted by Texas A&M University
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 -
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Sponsored by ZelisThe 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 -
Adeline Kon/Healthcare Dive
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
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