Government: Page 94


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    Litigation prompts Indiana to drop Medicaid work requirement for now

    State officials had said the regulation might reduce its Medicaid rolls by about 5%, or 70,000 out of a total enrollment of 1.4 million.

    By Ron Shinkman • Nov. 1, 2019
  • Georgia governor seeks to overhaul ACA market

    Gov. Brian Kemp's proposal would push customers away from Healthcare.gov and steer them to sign up for coverage using online portals run by brokers.

    By Ron Shinkman • Nov. 1, 2019
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    Price transparency rule on ice in win for providers

    The final outpatient payments rule from CMS did include plans to implement controversial site neutral provisions and cuts to 340B drug payments, both of which have been successfully challenged in court.

    By Nov. 1, 2019
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    FDA blames market failures for drug shortages

    High-profile shortages of drugs like EpiPen and the chemotherapy vincristine have brought attention to a chronic problem, one that's spurred in part by what the FDA termed a "broken marketplace."

    By Kristin Jensen • Nov. 1, 2019
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    Stephen Hahn, top MD Anderson official, will be next FDA chief

    Hahn emerged in September as the frontrunner for the job and will replace acting commissioner Ned Sharpless, pending confirmation by the Senate.

    By Ned Pagliarulo • Nov. 1, 2019
  • More than half of VBP hospitals will see bonus, similar to last year

    Rural hospitals participating in Medicare's Hospital Value-Based Payment Program significantly outperformed their urban counterparts, according to recent CMS data.

    By Ron Shinkman • Oct. 30, 2019
  • CMMI head predicts industry will be 'very happy' with his replacement

    "I worked very closely with the administration to identify somebody that has extremely similar values, that's concentrated on doing the right thing," Adam Boehler said Tuesday at the HLTH conference in Las Vegas.

    By Oct. 30, 2019
  • 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 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
  • 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 Oct. 28, 2019
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    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 Oct. 23, 2019
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    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 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
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    '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
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    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 Oct. 17, 2019
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    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
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    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
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    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 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
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    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 Oct. 15, 2019
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    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
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    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