Government: Page 93
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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 Parduhn • 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 Parduhn • Jan. 15, 2020 -
AHA files another challenge to CMS site neutral payment policy
The same court ruled in favor of hospitals in September, but later determined it could not keep CMS from attempting the policy again for 2020.
By Shannon Muchmore • Jan. 14, 2020 -
Dignity Health loses appeal of Medicaid out-of-network billing case
The hospital operator said it may try to take the case against L.A. Care, the largest public Medicaid managed care plan in the country, to the California Supreme Court.
By Ron Shinkman • Jan. 13, 2020 -
Supreme Court to take on PBM rate regulation
A federal appeals court previously ruled in favor of pharmacy benefit managers, finding federal law preempts states from regulating their rates.
By Samantha Liss • Jan. 13, 2020 -
A biotech startup launches with unusual goal: invent new drugs, and sell them for less
Founded by venture capitalist Alexis Borisy, EQRx will launch with $200 million in funding to prove out a vision as daunting as it is ambitious.
By Ned Pagliarulo • Jan. 13, 2020 -
The government recovered $3B in fraud last year. Nearly 90% was from healthcare
It marks the 10th consecutive year the DOJ has recouped more than $2 billion from False Claims Act settlements and judgments for HHS.
By Rebecca Pifer Parduhn • Jan. 10, 2020 -
Kansas to become 37th state to expand Medicaid under ACA
Kansas joins a flurry of Republican-leaning states that have either expanded the program through their legislatures or via voter initiative, including Utah, Idaho and Nebraska.
By Ron Shinkman • Jan. 10, 2020 -
US cancer death rate drops by most on record
Reductions in smoking and earlier cancer detection have driven death rates lower, but newer treatments could be playing a larger role, too.
By Ned Pagliarulo • Jan. 9, 2020 -
Kaiser, major union launching nonprofit to boost California workforce
The $130 million organization, called Futuro Health, has a goal of graduating 10,000 new licensed and credentialed workers for the state in the next four years.
By Shannon Muchmore • Jan. 9, 2020 -
Social risk factors may influence CMS star ratings, study suggests
Providers have disputed the methodology CMS uses to compile its star ratings for years, saying the approach is overly simplistic and the presentation of data to consumers is difficult to interpret.
By Linda Wilson • Jan. 9, 2020 -
Individual market appears stable despite lack of mandate penalty
Claims costs in the first nine months of 2019 grew and average hospital time dipped, indicating the market didn't have disproportionately sicker patients, according to the Kaiser Family Foundation.
By Shannon Muchmore • Jan. 8, 2020 -
CMS proposes using more encounter data for MA risk adjustment
The mix of encounter data used to calculate payments would go up to 75% next year under the proposed regulation. Payers have railed against previous increases, saying the information is inaccurate and unreliable.
By Shannon Muchmore • Jan. 7, 2020 -
Ex-Anthem exec Brad Smith appointed head of CMS innovation center
Smith, previously co-founder and CEO of palliative care company Aspire Health, replaces outgoing CMMI head Adam Boehler.
By Rebecca Pifer Parduhn • Jan. 7, 2020 -
Beyond the ACA: Healthcare legal fights to watch in 2020
Payers and providers are contesting a price transparency push. The Trump administration is also being challenged over risk corridor payments and the expansion of association health plans.
By Shannon Muchmore , Samantha Liss • Jan. 6, 2020 -
Alex Wong via Getty Images
Providers embrace loosening Stark Law regulations, suggest feds could go further
The Trump administration's proposed relaxation of regulations around the law has nearly unanimous support in both the hospital and physician community, most of whom say they are chafing against the requirements.
By Ron Shinkman • Jan. 6, 2020 -
Pfizer, AbbVie and Gilead among drugmakers boosting prices to start 2020
List prices rose on some of the top-selling medicines in the U.S., including Humira, Opdivo, Prevnar 13 and Biktarvy.
By Andrew Dunn • Jan. 2, 2020 -
Permission granted by Geisinger Health
Despite provider claims, hospital M&A not associated with improved care, NEJM finds
The findings refute a common provider justification for rampant M&A, but the American Hospital Association pushed back on researchers' reliance on patient surveys.
By Rebecca Pifer Parduhn • Jan. 2, 2020 -
Getty / Edited by Healthcare Dive
Tenet deal to sell Memphis properties raises hackles of other area providers
One health system said it is "reasonably certain the FTC will be reviewing this proposed transaction given the potential negative impact it could have on the consumers in Memphis."
By Ron Shinkman • Dec. 30, 2019
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