Government: Page 95
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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 -
Colorado's public option plan cuts provider rates to lower premiums
The state hospital association immediately slammed the proposal as akin to government rate-setting with "the potential to significantly damage the health insurance market in our state."
By Rebecca Pifer Parduhn • Oct. 9, 2019 -
Former FDA chief Gottlieb predicts Trump-pitched pricing model easy to game
"I don't want to give too much away, because I'll tell people how to game around this," said the former commissioner, who now sits on Pfizer's board of directors.
By Andrew Dunn • Oct. 9, 2019 -
As docs ditch primary care to become hospitalists, MedPAC warns of shortage
The number of hospitalists increased nearly 50% between 2010 and 2017 while the number of PCPs is basically flatlining, according to a new report from the Medicare advisory commission.
By Ron Shinkman • Oct. 7, 2019 -
Waste gobbles up 25% of US healthcare spending, JAMA study finds
In accompanying editorials, former CMS officials lamented that many initiatives aimed at cutting unnecessary spending haven't been that successful and blamed the political landscape.
By Dana Elfin • Oct. 7, 2019 -
Healthcare leads the way as US hits lowest unemployment mark in decades
"[T]he combination of strong demand growth from healthcare employers and shortages of many clinicians (nurses, physicians) creates a positive set-up for the healthcare temp staffing industry," Jefferies analysts wrote.
By Shannon Muchmore • Oct. 7, 2019 -
Trump signs executive order bolstering MA in pushback on 'Medicare for All'
The directive would let commercial Medicare plans offer more novel benefits and allow beneficiaries to join in on some of the savings payers are able to deliver through cash or rebates.
By Samantha Liss • Oct. 3, 2019 -
Ramping up rhetoric against 'Medicare for All,' Trump looks to bolster popular MA program
Though administration officials were light on details, they said an executive order the president will sign Thursday aims to expand access to healthcare providers and the latest therapies.
By Samantha Liss • Oct. 3, 2019 -
ACOs taking on risk performed better in Medicare program last year
Participants generated nearly $740 million in savings under the model, and most also earned quality improvement rewards.
By Shannon Muchmore • Oct. 2, 2019 -
Payers roll out 2020 MA plans with increased focus on social determinants
"Clearly, Medicare Advantage has the ability and the opportunity to innovate in ways that's just harder under fee-for-service," said Sean Creighton, managing director with Avalere.
By Shannon Muchmore • Oct. 2, 2019 -
Critics blast Trump admin's push for wellness initiative in ACA exchanges
"We've got loads of evidence that wellness programs do not work. They don't save money. They don't make people healthier. They're also creepy as all get-out," Nicholas Bagley, a health law expert, wrote on Twitter.
By Samantha Liss • Oct. 1, 2019 -
'A radical experiment': Payers, providers renew attacks on price transparency proposal
Industry groups skewered the rule as "the wrong approach," "anticompetitive," "confusing" and "missing the mark."
By Rebecca Pifer Parduhn • Sept. 30, 2019 -
DOJ charges 35 people in $2.1B Medicare genetic testing fraud scheme
CMS also announced it took adverse administrative action against testing companies and providers who filed more than $1.7 billion in claims to Medicare.
By David Lim • Sept. 30, 2019 -
Executives say lack of resources biggest obstacle to value-based care
Respondents to a Definitive Healthcare survey also noted interoperability gaps, an unpredictable revenue stream and the financial risk in value-based care initiatives as barriers.
By Ron Shinkman • Sept. 30, 2019 -
After California surprise billing law, fewer specialty services were out-of-network
The new report "strongly contradicts" the California Hospital Association's claims the law is destroying provider networks, a study author said.
By Shannon Muchmore • Sept. 27, 2019 -
Device makers must adapt to rise of ASCs, analysts say
Bain & Company experts predict medtech companies may consider new business models, such as taking equity stakes in ambulatory surgery centers, to drive use of their latest devices.
By Nick Paul Taylor • Sept. 27, 2019 -
CMS rules aim to reduce regulatory burden for providers
One of the agency's final rules posted Wednesday requires hospitals to create discharge evaluations for patients at risk of adverse health consequences and for anyone whose family requests one.
By Shannon Muchmore • Sept. 26, 2019 -
States pull back curtain on drug prices, to uncertain effect
A newly enacted law in Colorado requires pharma companies inform doctors of drug list prices, as well as the names of three generics in the same treatment class.
By Ned Pagliarulo • Sept. 25, 2019 -
Q&A
Does disclosure of pharma payments harm patient trust in doctors?
A counterintuitive finding raises questions about how transparency can be better managed, University of Pennsylvania researcher Genevieve Kanter told BioPharma Dive.
By Andrew Dunn • Sept. 25, 2019
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