Government: Page 89
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HHS chief keeps focus on alternative payment models
Alex Azar on Tuesday hinted at further pushes from CMS on value-based care, including population health benefits like those newly allowed in Medicare Advantage and flat monthly payments for a patient's total cost of care.
By Shannon Muchmore • Oct. 29, 2019 -
Sanford agrees to $20M settlement to resolve kickback allegations
The case centered on implants sold by a physician-owned distributorship and allegations a Sanford Health neurosurgeon used those devices to perform medically unnecessary procedures.
By Nick Paul Taylor • Oct. 29, 2019 -
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 -
CMS chief Verma teases more Medicaid deregulation
Speaking at the HLTH conference Sunday, Verma also said that as long as states continue to approach CMS with requests for Medicaid work requirements, the agency would approve them.
By Rebecca Pifer • Oct. 28, 2019 -
Deep Dive
Wave of deals expected as private equity eyes orthopaedic practices
The business of replacing hips and knees is a lucrative area for investors as joint replacements are expected to rise and more care migrates to outpatient settings.
Oct. 25, 2019 -
Verma dodges on backup plan if ACA is struck down
Democrats accused the CMS administrator of stonewalling in her testimony in front of a House committee Wednesday, with a federal appeals court ruling on the fate of the landmark law expected any day.
By Rebecca Pifer • Oct. 23, 2019 -
FTC takes aim at state-shielded rural monopolies
The agency will study certificates of public advantage in three states — Tennessee, Virginia and West Virginia — that immunized certain health system mergers from federal antitrust scrutiny.
By Samantha Liss • Oct. 22, 2019 -
Drug distributors, Teva settle in Ohio opioid case: reports
The four companies, which include AmerisourceBergen, McKesson and Cardinal Health, will reportedly pay $260 million to two Ohio counties to avoid a trial.
By Jonathan Gardner • Oct. 21, 2019 -
'Medicare for All' likely to keep private payers, but erode margins: Moody's
Several recent reports game out the costs and benefits of Democratic 2020 presidential hopefuls' healthcare proposals.
By Ron Shinkman • Oct. 18, 2019 -
Health IT advisory group targets price transparency, data security with eye toward 2020
HITAC members floated the idea of establishing a workgroup focused solely on price transparency, with one panel member calling it an area of "high interest, especially for consumers."
By Rebecca Pifer • Oct. 17, 2019 -
Key committee pitches adding UDIs to insurance claim forms, called 'huge step'
If a unique device identifier is captured when a high-risk product is implanted, providers will be able to detect complications more quickly, said Joe Drozda, the director of outcomes research at Mercy Health.
By David Lim • Oct. 16, 2019 -
Sutter settles antitrust case, terms unknown
The agreement, reached just as the landmark trial was set to begin, is expected to be finalized in February or March.
By Dana Elfin • Updated Oct. 18, 2019 -
Overwhelming majority of providers loathe prior authorization requirements, survey shows
HHS is attempting to address the issue, proposing a rule in June to update electronic prior authorization requirements in Medicare Part D plans. The head of ONC has also called for an overhaul of the process.
By Shannon Muchmore • Oct. 16, 2019 -
Medicare, Medicaid hospital payment cuts to hit $252.6B, industry study finds
"Hospitals are nearing the tipping point we have predicted for so long," Chip Kahn, CEO of the Federation of American Hospitals, said of the report commissioned by his group and AHA.
By Linda Wilson • Oct. 16, 2019 -
Pelosi plan would cut Medicare drug spending by $370B, CBO says
The proposal to require direct price negotiation between the federal government and the pharmaceutical sector stands little chance of quick action, but drugmakers are on defense nonetheless.
By Jonathan Gardner • Oct. 15, 2019 -
California bill to end excessive dialysis profits becomes law
Fresenius said it's concerned the new law will result in patients only being able to access care at hospitals due to lack of insurance coverage.
By Susan Kelly • Oct. 15, 2019 -
Oscar files appeal in battle with Florida Blue over exclusive broker policies
A federal judge ruled against the startup last month, despite the U.S. Department of Justice arguing the case should not be tossed.
By Samantha Liss • Oct. 15, 2019 -
Hospitals, manufacturers could donate cybersecurity software under proposed regs
With the cost of protecting systems from malicious hackers increasing, the idea to tweak the anti-kickback laws recognizes some physician practices don't have the resources or expertise to keep pace, one lawyer said.
By David Lim • Oct. 14, 2019 -
CMS issues 2020 star ratings for Medicare Advantage plans; Kaiser dominates
Centene and WellCare did not fare so well as the two attempt to wrap up their merger, a finding one analyst called "less-than-inspiring."
By Ron Shinkman • Oct. 14, 2019 -
Premier joins forces with Amphastar on 7 drugs in short supply
The agreement is another example of how healthcare companies are searching for new ways to address drug shortages.
By Kristin Jensen • Oct. 11, 2019 -
Appeals court judges skeptical of Medicaid work rule aims
During oral arguments in D.C. on Friday, a three-judge panel pressed for answers on why beneficiaries were losing coverage under the new requirements.
By Samantha Liss • Oct. 11, 2019 -
For COPD patients with high deductibles, more trouble getting care
Authors of the study said plans that "raise out-of-pocket costs or give individuals more 'skin in the game' could harm patients."
By Shannon Muchmore • Oct. 10, 2019 -
Alex Wong via Getty Images
Providers mostly cheer anti-kickback revamp but some still wary
The Medical Group Management Association said the proposals fall short, citing a need for clarity on imaging, physical therapy and laboratory services as well as an overhaul of penalties.
By Samantha Liss • Oct. 10, 2019 -
Fresenius to pay $5.2M to settle Medicare overbilling allegations
DOJ alleged the company overbilled Medicare for more than seven years by ordering hepatitis B tests for patients it knew to be immune to the virus.
By Nick Paul Taylor • Oct. 10, 2019 -
Elizabeth Regan/Healthcare Dive
With new report, ICER puts itself at center of drug pricing storm
Pharma price hikes added billions of dollars to U.S. spending in 2017 and 2018. For seven top drugs, the watchdog found those increases came with little new clinical evidence in support.
By Ned Pagliarulo • Updated Oct. 8, 2019 -
Alex Wong via Getty Images
HHS pitches sweeping revamp of Anti-Kickback Statute, Stark Law
The department proposed several new safe harbors to encourage value-based care, allow patient engagement through furnishing of tools and supports and permit certain remuneration in some CMS-sponsored models.
By David Lim • Oct. 9, 2019
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