Payers, providers urge CMS to scrap rule targeting supplemental Medicaid payments

The AHA warned the rule would "severely curtail the availability of health care services to millions" of people and cut Medicaid payments to hospitals by up to $31 billion annually.

By Samantha Liss • Feb. 3, 2020

CMS exchange rules for 2021 target premium subsidies

The agency is also seeking comments on a proposal requiring low-income exchange enrollees who pay no premiums to revisit the exchange during open enrollment to assert they're entitled to the same subsidy the following year.

By Ron Shinkman • Feb. 3, 2020

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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

Payers, employers protest price transparency rule as wrong-headed

Most of the 23,355 public comments expressed skepticism or all-out opposition to the Trump administration's proposal targeting insurers.

By Samantha Liss • Jan. 31, 2020

The Trump administration is offering Medicaid block grants. Which states will say yes?

So far, the governors of Oklahoma and Arkansas have both expressed explicit support for the guidance allowing states to cap payments for adults who became eligible for Medicaid under the 2010 ACA expansion.

By Rebecca Pifer • Jan. 30, 2020

Codes for social determinants rarely used, analysis finds

The most frequently used code was for homelessness, followed by problems related to living alone and disappearance and death of a family member, according to CMS.

By Shannon Muchmore • Jan. 30, 2020

Trump admin to allow Medicaid caps, but legal fight likely as providers protest

Providers were quick to attack the highly anticipated plan giving states the option of accepting block grants for payment in the safety-net program, choosing between a per-enrollee or total coverage budget.

By Rebecca Pifer • Updated Jan. 30, 2020

Privacy versus access debate rages on, rekindled by Epic lobbying

Promoting interoperability without clear guardrails could lead to healthcare's version of Cambridge Analytica, Epic wrote in a public statement coinciding with ONC's annual health IT conference.

By Rebecca Pifer • Jan. 29, 2020

Backing for unique patient identifier picks up steam at ONC conference

The current ban on funding UPIs is "misguided policy," Rep. Bill Foster, D-Ill., said Monday at the gathering of IT and industry officials. But other experts warned it's "not a panacea."

By Rebecca Pifer • Jan. 28, 2020

Providers won't be financially liable for info blocking in final ONC rule, due any day

"This final rule won't dive into penalties for providers," the country's health IT chief Don Rucker told Healthcare Dive on the sidelines of the agency's annual conference. "There will be future rulemaking on that."

By Rebecca Pifer • Jan. 28, 2020

Practice Fusion pays $145M in 1st criminal action against EHR vendor

DOJ charged the San Francisco-based company, now a subsidiary of Allscripts, with two felony counts for soliciting kickbacks in exchange for using its software to encourage doctors to prescribe more opioids.

By Shannon Muchmore • Jan. 28, 2020

Drug rebates from 340B, Medicaid could be applied twice, GAO finds

Poor oversight of the 340B Drug Discount Pricing Program and the Medicaid Drug Rebate Program may allow providers to improperly receive discounts from both, the watchdog said.

By Hailey Mensik • Jan. 28, 2020

Patient use of digital tools, 3rd-party apps to access health records rises in 2019

One in five patients granted third-party apps access to their health data last year, reviving privacy concerns as the industry waits for HHS to finalize rules setting standards around interoperability.

By Rebecca Pifer • Jan. 27, 2020

Providers warned to be vigilant as coronavirus fear spreads

"We want people to have a high index of suspicion and to call if they have a patient they're concerned about," a CDC official said Sunday. Five cases are now confirmed in the U.S., but officials said they expect the number to climb.

By Shannon Muchmore • Jan. 27, 2020

ACA slashed uninsured rate, but number who can't afford care still rising

Between 1998 and 2017, the proportion of the U.S. population unable to see a doctor due to the associated costs of doing so rose from 11.4% to 15.7%, according to a new JAMA Internal Medicine study.

By Ron Shinkman • Jan. 26, 2020

Impeachment trial, election won't dampen health investment, Fitch says

Despite the potential for regulatory changes late in the year, the outlook for healthcare products and services remains strong and the frenetic pace of M&A is unlikely to slow much, according to the ratings agency.

By Rebecca Pifer • Jan. 24, 2020

Surescripts loses motion to dismiss FTC antitrust case

The e-prescribing giant argued the regulator's suit is procedurally defective, but a federal judge agreed with the bureau Friday in denying Surescripts' motion to dismiss.

By Rebecca Pifer • Jan. 23, 2020

New conservative faction to lobby against benchmark surprise billing fix

The argument against a benchmark rate is popular among provider lobbies, which have spent millions to oppose such proposals — including White House-backed legislation from Senate and House heavyweights.

By Rebecca Pifer • Jan. 22, 2020

UnitedHealth, Humana among Medicaid contracts nixed in Louisiana after protest

The decision came in response to appeals filed by Centene and Aetna, which were denied new contracts. The state will now redo the bidding process.

By Hailey Mensik • Jan. 22, 2020

HHS price transparency efforts may decode only sliver of total spending

A new examination of the push for more price transparency in healthcare concludes that while it "is not trivial, it does limit the potential impact of consumer-focused initiatives."

By Ron Shinkman • Jan. 21, 2020

Nation's 2nd-largest physician group backs 'Medicare for All'

The American College of Physicians said a single-payer approach would cut administrative burden, freeing more time for patient care, but would be "politically difficult" and "highly disruptive" to implement.

By Shannon Muchmore • Jan. 21, 2020

FTC commissioner pledges hard line on hospital mergers

Lobbyists and legislators also spoke at a Council for Affordable Health Coverage forum, noting a surprise billing ban is still on the table for Congress despite disagreements over the policy to achieve it.

By Shannon Muchmore • Jan. 17, 2020

MedPAC finds 340B effect on pricing 'modest,' going against pharma critique

The commission's report provides some new ammunition in the ongoing battle between pharmaceutical companies and nonprofit disproportionate share hospitals over the future of the 340B drug discount program.

By Rebecca Pifer • Jan. 17, 2020

After 2 years of turmoil, state exchange premiums stable for now, report finds

More robust reinsurance programs and commercial offerings from insurers such as Bright Health and upstart Oscar are playing a role, according to the Robert Wood Johnson Foundation and Urban Institute.

By Ron Shinkman • Jan. 17, 2020

Racial and ethnic disparities in care narrowed under ACA, Commonwealth Fund says

Previous progress in lowering the uninsured rate stalled after 2016.

By Linda Wilson • Jan. 16, 2020

Trump admin releases 5-year health IT roadmap as industry waits for interoperability update

The report will not impact long-awaited rules promoting interoperability in healthcare, which HHS plans to release early this year.

By Rebecca Pifer • Jan. 15, 2020