COVID-19 creates thicket of legal concerns for providers

"There's a push and pull here ... between offering patients protection and between providing immunities" to let providers operate without fear of prosecution, one expert said.

By Shannon Muchmore • June 5, 2020

Providers call CARES funds a lifeline — but some say headaches not worth risks

Legal experts Healthcare Dive spoke with had provider clients opting to return the funds, citing unwillingness to accept the terms and fears over potential risks that come with accepting the money.

By Samantha Liss • June 4, 2020

Explore the Trendline➔

Surprise Billing

Federal legislation banning surprise bills has hit a barrage of roadblocks, complicating efforts to protect consumers from unexpected out-of-network charges.

By Healthcare Dive staff

Months into pandemic, Trump admin mandates labs report demographic data of COVID-19 tests

HHS is now requiring labs to submit a much broader range of demographic COVID-19 testing data, including age, race, ethnicity and sex.

By Rebecca Pifer Parduhn • Updated June 5, 2020

BCBS plans account for nearly half of ACA enrollment, but face rising competition from Medicaid insurers

Medicaid insurers' market share on the exchanges overall ballooned from 15% of the marketplace in 2016 to 27% by 2018.

By Hailey Mensik • June 3, 2020

Governors plead for Trump admin to streamline testing supply distribution

"The surprise element is, here we're competing against other states and sometimes our own federal government," Colorado Gov. Jared Polis, a Democrat, told a House subcommittee Tuesday.

By Rebecca Pifer Parduhn • June 3, 2020

CMS relaxing more value-based model requirements in wake of pandemic

The changes are aimed at minimizing reporting burden and increasing flexibilities for providers as they continue to face great financial and logistical challenges from the novel coronavirus.

By Shannon Muchmore • June 3, 2020

Medicaid expansion key indicator for rural hospitals' financial viability

Other factors that play a positive role include tax-exempt status and occupancy rates, according to a study in Health Affairs.

By Hailey Mensik • June 2, 2020

Hospitals push for release of $50B more in COVID-19 funds

The American Hospital Association wants the money for all hospitals but also hot spot areas and facilities that serve a higher number of uninsured and Medicaid members.

By Samantha Liss • June 2, 2020

Pandemic highlights need for unique patient identifier, industry tells ONC

"We want to see that ban removed and hope we can have that conversation on a national level," Mark Probst, VP and CIO of Intermountain, said at the virtual conference.

By Rebecca Pifer Parduhn • June 2, 2020

Providers show support amid unrest: #WhiteCoatsForBlackLives

Health officials also expressed worry that the protest gatherings could further spread of the novel coronavirus. Some COVID-19 testing sites have been shut down for safety reasons, further exacerbating concerns.

By Shannon Muchmore • June 2, 2020

Citing lack of funding, Oklahoma withdraws planned July 1 Medicaid expansion

Millions of Americans have likely been booted off their employer-sponsored insurance and many are newly eligible for Medicaid, something the state didn't anticipate when prepping for the expansion, Republican Gov. Kevin Stitt said.

By Rebecca Pifer Parduhn • June 1, 2020

Molina, Centene big winners in Kentucky Medicaid award

The lucrative contracts begin next year and cover 1.4 million people with an annual spend of $8 billion.

By Samantha Liss • June 1, 2020

Pathologists most frequent surprise billing offenders, HCCI finds

More than a third of pathologists who billed for inpatient visits did so on an out-of-network basis more than 90% of the time in 2017, according to the Health Care Cost Institute.

By Rebecca Pifer Parduhn • May 28, 2020

BCBS plans sue CVS alleging overcharging generic prescriptions

Blue Cross Blue Shield plans in six states contend that CVS Health concealed the true cash price from the insurers for more than a decade. The plans are seeking to recoup millions from CVS.

By Samantha Liss • May 28, 2020

Cancer, spine doc leaders among top recipients of drug, device industry funds, study finds

Officials at 10 influential medical associations in the U.S. have extensive financial ties to industry, according to a study published Wednesday in BMJ.

By Samantha Liss • May 28, 2020

Medicare members using telehealth grew 120 times in early weeks of COVID-19 as regulations eased

CMS head Seema Verma said her department is evaluating the telehealth waivers to determine if they should be extended past the scope of the national emergency, and is in the process of additional rulemaking around the issue.

By Rebecca Pifer Parduhn • May 27, 2020

How tariffs ravaged the COVID-19 medical supply chain

Months into the pandemic, the U.S. faces an ongoing shortage of PPE and some of it is still subject to tariffs.

By Deborah Abrams Kaplan • May 27, 2020

COVID-19 has forced nearly half of patients to postpone care

About a third of those who have put off treatment said they would seek it in the next three months, and 10% said they will do so in four months to a year, according to a new survey from the Kaiser Family Foundation.

By Shannon Muchmore • May 27, 2020

Here's how much for-profit hospitals have received in COVID-19 bailout funding so far

The nation's largest for-profit hospital chains have received about $2.2 billion​, money they don't have to pay back. Healthcare Dive is tracking how much major health systems have collected in federal relief.

By Samantha Liss • May 26, 2020

Over 1,750 Part D, MA plans applied for new CMS insulin model

Payers cheered the effort to lower insulin costs and drugmakers Eli Lilly, Novo Nordisk and Sanofi have said they plan to participate. But powerful lobby PhRMA pushed back against the model.

By Rebecca Pifer Parduhn • May 26, 2020

What hospitals are doing to make patients feel comfortable coming back

Health systems face worried patients, according to recent polls. But volumes are picking back up in states where restrictions have been lifted.

By Hailey Mensik • May 22, 2020

MA, Part D final rule gives more star ratings weight to patient experience

The rule also attempts to let more MA plans comply with network adequacy standards by reducing the percentage of rural beneficiaries that must reside within maximum time and distance areas.

By Shannon Muchmore • May 22, 2020

PAs gain authority during COVID-19 pandemic, but still face layoffs, furloughs

Over the past few months, 21 states have taken action — eight through executive orders — to waive practice requirements for physician assistants. But the financial strain on health systems has also led to job cuts.

By Hailey Mensik • May 20, 2020

Despite $33M in approvals, FCC has sent just 1 provider CARES telehealth funds

"We expect the number of invoices to increase steadily as more funding continues to be approved," an FCC spokesperson told Healthcare Dive.

By Rebecca Pifer Parduhn • May 20, 2020

States brace for 'nearly certain' Medicaid budget shortfalls amid COVID-19

The Kaiser Family Foundation survey comes as the House passed a $3 trillion legislative relief package Friday, which would further bump the federal match rate for Medicaid.

By Rebecca Pifer Parduhn • May 18, 2020