Government: Page 73
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4M added to Medicaid rolls due to coronavirus pandemic
The job market — which many rely on for commercial insurance coverage — is likely to remain strained as long as the U.S. fails to contain the spread of the novel coronavirus. The resulting shift in payer mix is unfavorable for providers.
By Samantha Liss • Oct. 1, 2020 -
HHS launching effort to better track office-based EHR use
Office-based physicians' responses to surveys tracking health IT utilization have been waning. A new partnership with the American Board of Family Medicine is meant to revitalize data collection to inform future rulemaking.
By Rebecca Pifer • Sept. 30, 2020 -
Trendline
Labor
Hospitals are navigating persistent labor shortages with the need to cut costs — a source of contention that could leave patients caught in the middle.
By Healthcare Dive staff -
Rangel, David. [photograph]. Retrieved from https://unsplash.com/photos/4m7gmLNr3M0.
Anthem to pay almost $40M to settle 2015 cyberattack investigation
The settlement ends a long-standing investigation into the payer following a series of targeted hacks that exposed the health information of almost 79 million people. Anthem continues to deny any wrongdoing.
By Hailey Mensik • Sept. 30, 2020 -
6.5M Abbott COVID-19 antigen tests to reach states this week
Initial distribution of the rapid point-of-care diagnostics is meant to help reopen economies and schools, President Donald Trump said. It's still far short of the 200 million some experts say are needed each month.
By Greg Slabodkin • Sept. 30, 2020 -
Alex Wong via Getty Images
HHS says nearly $106B in CARES aid has been distributed to providers
Health systems are concerned, however, that new reporting guidelines issued by HHS could stanch the flow of money in the near future.
By Ron Shinkman • Sept. 28, 2020 -
Trump administration may push back interoperability rules, again: Rucker
HHS is "looking at needed changes" to deadlines for its information blocking rules, ONC head Don Rucker said last week. His comments followed a rule quietly sent to OMB with a title implying extension of certain compliance dates.
By Rebecca Pifer • Sept. 28, 2020 -
The White House/Healthcare Dive, data from WhiteHouse.gov
Trump health plan called 'pixie dust' on pre-existing conditions, builds on transparency bid
Despite talk by President Donald Trump to preserve pre-existing condition protections, his administration has undermined those protections through litigation and policy decisions.
By Hailey Mensik • Sept. 25, 2020 -
Experts seek answers on why few Medicaid providers sought COVID-19 relief
Just $2.2 billion of the $15 billion set aside has been paid out as of Sept. 11, a presentation by MACPAC staff found. Commissioners asked if a deadline should be reopened.
By Samantha Liss • Sept. 25, 2020 -
CMS touts dip in Medicare Advantage premiums for 2021
SVB Leerink analysts point to Centene, Humana and UnitedHealthcare as payers best positioned to pick up more share next year.
By Samantha Liss • Sept. 25, 2020 -
Biden preferred over Trump on COVID-19, pre-existing conditions, poll finds
Those younger, Black and Hispanic were more likely to list the pandemic as the top concern while older and White voters choose protecting health insurance coverage, The Commonwealth Fund survey found.
By Shannon Muchmore • Sept. 24, 2020 -
Primary care docs call for federal aid as 1/3 still face significantly low revenue
The new weekly survey from the Larry A. Green Center and Primary Care Collaborative shows a slightly rosier snapshot for primary care providers but suggests trouble ahead amid zero action from Congress and the flu season.
By Rebecca Pifer • Sept. 23, 2020 -
Opinion
Medicare Advantage should not 'game the system' but prioritize patient care, honest billing
The HHS Office of Inspector General's principal deputy warns, "My office and other government agencies are targeting oversight to make sure plans do not pad risk adjustments with unsupported diagnoses."
By Christi A. Grimm • Sept. 23, 2020 -
Payers, other stakeholders urge Congress to blunt COVID-19-spurred insurance losses
"The odds are we are on track to having the greatest coverage losses we've ever recorded," Stan Dorn, director of the National Center for Coverage Innovation and senior fellow at Families USA, said during a briefing Tuesday.
By Samantha Liss • Sept. 23, 2020 -
CMS to expand ambulance prior authorization model nationwide
The model saved Medicare about $650 million in four years without changing care quality or access. However, the timeline for its rollout is still to be determined amid COVID-19 uncertainty.
By Rebecca Pifer • Sept. 23, 2020 -
Georgia practice to pay $1.5M after hacker accessed thousands of patient records
The group calling itself The Dark Overlord used a vendor's credentials and attempted to sell the data, including medical procedures and other personal information, online.
By Shannon Muchmore • Sept. 22, 2020 -
CMS to push back radiation oncology model after industry blowback
Agency administrator Seema Verma said the upcoming rulemaking will formalize a 6-month delay because "more time is needed to prepare."
By Susan Kelly • Updated Oct. 22, 2020 -
Hospitals charge privately insured patients 250% more than those on Medicare. The gap is growing.
A RAND study of charge data from more than 3,000 hospitals points the finger at growing provider consolidation as a key culprit, but the AHA slammed the report as "based on a cherry-picked and limited dataset."
By Ron Shinkman • Sept. 18, 2020 -
Trump admin unveils final mandatory kidney care payment model
Forced participation in the ESRD model, where CMS will identify providers in randomly selected regions to take part, drew industry ire when it was first proposed one year ago.
By Samantha Liss • Sept. 18, 2020 -
'We feel bullish': Payers look ahead to 2021
Top execs at the biggest commercial insurers outlined shifting strategic priorities and growth opportunities in light of the COVID-19 recession at Morgan Stanley's annual healthcare conference last week.
By Rebecca Pifer • Sept. 17, 2020 -
Alex Wong via Getty Images
CMS innovation agency to launch risk-based model for dual eligibles
Along with the dual-eligible demonstration, CMMI head Brad Smith said Tuesday industry could expect some additional models to come out of the pipeline in the next few months.
By Rebecca Pifer • Sept. 16, 2020 -
OCR settles with 5 more providers on HIPAA right of access violations
Three of the providers failed to give the patient medical records access until after a second complaint to the HHS Office of Civil Rights was submitted and validated.
By Shannon Muchmore • Sept. 16, 2020 -
Uninsured rate rose to 9.2% in US last year, pre-COVID-19 recession
The high cost of U.S. healthcare continues to stress the country's economic outlook overall. About 7.7 million more Americans would be considered low-income if their medical bills were factored in, the U.S. Census Bureau said.
By Rebecca Pifer • Sept. 16, 2020 -
FTC urges Texas regulators to block merger under COPA
The agency was blistering in its comments, warning regulators the deal would result in serious competitive and consumer harm in the form of higher prices, lower quality and diminished access to care and innovation.
By Samantha Liss • Sept. 15, 2020 -
CMS to ax inpatient data in MA risk scoring by 2022
The proposed changes should be a net positive for Medicare Advantage players, resulting in a 0.25% rise in risk scores.
By Rebecca Pifer • Sept. 15, 2020 -
Naomi Eide/Healthcare Dive
OSHA fines 3 hospital systems for PPE violations
Bergen New Bridge Medical Center said Monday afternoon it had not received the OSHA report but will "respond accordingly" when it does. The other two hospitals have not responded to requests for comment.
By Ron Shinkman • Updated Sept. 15, 2020
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