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

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

AHA moves to shift cost blame to health plans in letter to antitrust regulators

The letter included an updated AHA-funded study on the benefits of hospital mergers, which was previously criticized by outside experts for cherry-picked data, among other methodological weaknesses.

By Rebecca Pifer Parduhn • Aug. 19, 2021

The federal price transparency rules have critical gaps that must be addressed to achieve their objectives

Castlight Health CEO Maeve O'Meara argues that if regulations aren't implemented in a meaningful way for consumers, the efforts will likely fail to inform healthcare decision making and achieve the desired cost savings.

By Maeve O'Meara • Aug. 18, 2021

Payments to MA plans raised overall Medicare spend by $7B in 2019, analysis finds

The Kaiser Family Foundation chalked the higher spending up to how MA is paid, including how benchmarks for plan payments are set and the risk adjustment process.

By Rebecca Pifer Parduhn • Aug. 18, 2021

US to offer coronavirus boosters to all Americans in aggressive plan to counter delta's spread

The Biden administration's call comes ahead of FDA authorization for additional doses in people who aren't immunocompromised, although agency head Janet Woodcock joined other officials in supporting the plan.

By Ned Pagliarulo • Updated Aug. 18, 2021

Medtechs need to up their cybersecurity threat modeling game, FDA says

The agency "will be looking for much more detailed and comprehensive" cyber threat models as part of premarket review, said Suzanne Schwartz, director of CDRH's Office of Strategic Partnerships and Technology Innovation.  

By Greg Slabodkin • Aug. 18, 2021

CMS extends deadlines for Medicaid redeterminations after COVID-19 public health emergency ends

Due to significantly increased workloads, state health officials will now have 12 months instead of six after the PHE ends to complete pending verifications, redeterminations and renewals.

By Hailey Mensik • Aug. 17, 2021

FDA authorizes third coronavirus vaccine dose for immunocompromised people

A CDC advisory panel is expected to vote on Friday to recommend the additional dose, after which certain people with weakened immune systems can receive a third shot of Pfizer's or Moderna's vaccine.

By Shoshana Dubnow • Aug. 13, 2021

UnitedHealth settles for $15.6M after Labor Department finds mental health cuts, denials

"You should expect to see more investigation," of those not abiding by the federal mental health parity law, a top DOL official said. "I predict this will be a very active issue for us for years to come."

By Shannon Muchmore • Aug. 12, 2021

Biden embraces Medicare drug price negotiation as Democrats seek to widen health coverage

But the proposal, which features several familiar and long-debated policy ideas, could face an uphill battle in Congress as the drug industry lines up against it.

By Jonathan Gardner • Updated Aug. 12, 2021

HCA accused of hospital monopoly in North Carolina

After acquiring Mission Health System in 2019, the hospital operator has continued tactics of all-or-nothing arrangements with payers and gag clauses, driving up prices and insurance premiums, the class action complaint alleges.

By Shannon Muchmore • Aug. 11, 2021

HHS 'making progress' on disincentives for providers found info blocking, ONC head says: HIMSS21

The fact that HHS has yet to codify appropriate disincentives for providers found guilty of information blocking is probably the "biggest gap to be filled on the enforcement side," Micky Tripathi said.

By Rebecca Pifer Parduhn • Aug. 10, 2021

Digital therapeutics — a double-edged sword?

Aloha McBride, EY's global health leader, argues that algorithms need to be regularly audited and screened for bias and discrepancies, while clinicians play a vital role in explaining the key features of apps and patient privacy risks.

By Aloha McBride • Aug. 10, 2021

Delaware caps hospital price growth to fund more primary care

Gov. John Carney signed the multi-pronged healthcare bill on Friday. "As I think about the things, particularly in healthcare that we focus on, there's not much that's more important than this," he said.

By Samantha Liss • Updated Oct. 5, 2021