Government: Page 75
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Payers win again, court rules Trump admin violated law in axing ACA cost-sharing payments
Judges said, however, that insurers able to raise premiums to offset the loss of the payments in 2018 should not receive the entire unpaid amount.
By Shannon Muchmore • Aug. 14, 2020 -
Oklahoma pulls Medicaid block grant application
The move comes after the state's voters narrowly approved Medicaid expansion last month and is a blow to the Trump administration's attempt to overhaul the program with block grants, long a conservative policy goal.
By Hailey Mensik • Aug. 14, 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 -
As Congress eyes an inquiry into insurer profits, experts caution they may not last
"One thing that we can be certain of is that the lower level of claims cost experienced in the second quarter will not continue indefinitely," Bradley Ellis, senior director of North American insurance ratings for Fitch Ratings, said.
By Samantha Liss • Aug. 12, 2020 -
Biden VP pick Harris, early backer of 'Medicare for All,' later pivoted
Among the largest donors to Sen. Kamala Harris' primary run were workers, owners and political action committees associated with healthcare powerhouse Kaiser Permanente.
By Shannon Muchmore • Aug. 12, 2020 -
20 state AGs urge Trump admin to nix proposed tax breaks for health sharing ministries
Saying it would undermine the Affordable Care Act and encourage fraud, the attorneys general called a draft rule arbitrary and particularly dangerous amid the COVID-19 pandemic.
By Ron Shinkman • Aug. 12, 2020 -
New CMS value-based payment model aimed at rural hospitals, ACOs
The program will include upfront and capitated payments for providers as well as some regulatory flexibilities. It will require facilities to partner with state Medicaid agencies in an attempt to improve care coordination.
By Shannon Muchmore • Aug. 11, 2020 -
"White House Coronavirus Update Briefing". Retrieved from The White House.
State coronavirus testing plans diverge wildly, some intend slowdown by December
Monthly testing target reports submitted to HHS show Connecticut and Illinois seek to scale up, for example, while Louisiana and Maine predict lower volume by the end of the year.
By Maria Rachal • Aug. 11, 2020 -
OIG says hospitals overbilled Medicare $267M by improperly coding post-discharge services
The watchdog recommended CMS direct its recovery audit contractors to recoup overpayments made within the past four years.
By Ron Shinkman • Aug. 10, 2020 -
Telehealth claims dipped in May, but still up 5,680% from year ago: Fair Health
The latest insurance data found private claims for virtual care fell 33% from April, but are still wildly up amid lockdowns and the ongoing pandemic.
By Ron Shinkman • Aug. 7, 2020 -
Trump tries to revamp drug supply chain with latest order
A directive announced by the president Thursday would require government agencies to buy certain "essential" drugs from factories in the U.S. How easily such an order would be implemented isn't clear.
By Ben Fidler • Aug. 7, 2020 -
DOJ sues Cigna, alleging $1.4B in Medicare Advantage fraud
The payer used a medical assessment program to find health conditions that could raise risk scores of plan members, offering incentives to physicians who gave the exam, according to the lawsuit.
By Hailey Mensik • Aug. 6, 2020 -
Fresh off Medicaid win in Missouri, Fairness Project calls for health industry to step up
"We need to see health insurers and private hospitals step up and make massive investments in these campaigns," Jonathan Schleifer, executive director of the D.C.-based advocacy group, told Healthcare Dive.
By Samantha Liss • Aug. 6, 2020 -
Missouri voters usher in Medicaid expansion
It's the latest red state to take the issue of expanded access to government-sponsored health coverage to its voters, ringing in a victory via an amendment to the state's constitution.
By Samantha Liss • Aug. 5, 2020 -
Brian Tucker/Healthcare Dive
CMS proposes eliminating inpatient-only list
The agency said the COVID-19 pandemic has "highlighted the need for more healthcare access points throughout the country," including ambulatory surgical centers.
By Shannon Muchmore • Updated Aug. 4, 2020 -
The White House/Healthcare Dive, data from WhiteHouse.gov
CMS expands telehealth coverage in physician fee rule following Trump executive order
The agency proposed making permanent almost two dozen new telehealth codes. A notable exception is Medicare's temporary reimbursement for audio-only visits, though the agency did ask for public input on the omission.
By Rebecca Pifer • Aug. 4, 2020 -
COVID-19 caused hospital ED visits to dive more than 40%
Researchers in JAMA examined trends at major providers such as Mount Sinai Health, Baystate Health and Yale-New Haven, also finding emergency patients were more likely to be admitted.
By Ron Shinkman • Aug. 3, 2020 -
Quarter of Medicare members can't access telehealth visits, JAMA studies show
The gallop to digital delivery of care may have left more marginalized populations without access to high-speed internet, a smartphone or even a computer behind, two studies suggest.
By Rebecca Pifer • Aug. 3, 2020 -
House panel finds Trump admin bungled Philips ventilator deal, overpaid by $500M
Philips denied raising prices to benefit from the COVID-19 crisis and said it is on track with scheduled production and delivery of ventilators.
By Susan Kelly • Aug. 3, 2020 -
Hospitals consider Supreme Court appeal in 340B drug payment cut case
Judges have denied a request from the American Hospital Association and other plaintiffs to have the case reheard before the full bench after the nearly 30% rate reduction was upheld in July.
By Shannon Muchmore • Updated Oct. 20, 2020 -
US promises $2.1B to Sanofi, GSK in latest coronavirus vaccine deal
The contract is the largest yet from the Trump administration's Operation Warp Speed, although Sanofi and GSK have yet to begin clinical testing of their shot.
By Ned Pagliarulo • July 31, 2020 -
HHS prods Congress to act on surprise billing, but doesn't take a side on how
Congress has taken some action on surprise billing in the face of the coronavirus pandemic, barring the practice for COVID-19 testing and treatment during the public health emergency. Still, a larger overhaul is unlikely soon.
By Shannon Muchmore • July 29, 2020 -
Telehealth made up almost half of all Medicare beneficiaries' primary care use in April
Fee-for-service beneficiaries adopted telehealth for primary care at unprecedented rates as COVID-19 spread in the U.S., according to a new HHS report.
By Rebecca Pifer • July 29, 2020 -
CMS to begin recouping COVID-19 Medicare loans
Hospital groups have pleaded with the Trump administration and Congress to forgive the loans, or relax repayment terms, with no relief so far.
By Rebecca Pifer • July 27, 2020 -
Brian Tucker/Healthcare Dive
Deep DiveAfter 6 months of darkness, primary care practices see little light ahead
"You have to dig yourself out of a financial hole — it's not a hole, it's a crater — created by the pandemic," said Gary LeRoy, president of the American Academy of Family Physicians.
By Rebecca Pifer • July 27, 2020 -
Yujin Kim/Healthcare Dive
What it's like to be a nurse after 6 months of COVID-19 response
"I think the biggest change is we always relied on science, and we have always relied heavily on infection control protocols to guide our practice," a nurse working on the frontlines said. "Now infection control is out of control, we can no longer rely on the information and resources we always have."
By Hailey Mensik • July 27, 2020
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