Senators push CMS, commercial payers on bias in algorithms

The letters sent to UnitedHealth, Blue Cross Blue Shield, Cigna, Humana and Aetna flagged a study that found racial bias in a widely used algorithm for assessing healthcare needs.

By Susan Kelly • Dec. 4, 2019

Hospitals sue HHS, warning price transparency rule would chill competition, crash computers

An agency spokeswoman shot back that hospitals "should be ashamed that they aren't willing to provide American patients the cost of a service before they purchase it."

By Samantha Liss • Dec. 4, 2019

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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

'Refusal to properly report' data breach spurs $2.175M fine for Sentara Hospitals

"When healthcare providers blatantly fail to report breaches as required by law, they should expect vigorous enforcement action," HHS Office of Civil Rights chief Roger Severino said.

By Ron Shinkman • Dec. 2, 2019

Fitch says 2020 healthcare environment bumpy but negotiable

The legal fate of the Affordable Care Act is one of several uncertainties, according to the report. Ongoing opioid litigation is another.

By Ron Shinkman • Nov. 27, 2019

US life expectancy down in recent years after increasing for decades

Researchers noted the decline comes despite the U.S. spending far more than other high-income countries on healthcare. Deficiencies in the system "could potentially explain increased mortality from some conditions," they wrote.

By Shannon Muchmore • Nov. 26, 2019

Mandatory CMS radiation oncology model goes on backburner

Originally, the agency was eyeing an implementation date as early as Jan. 1, but the new regulatory agenda lists July 2022 as a target date for the bundled payment model.

By David Lim • Nov. 26, 2019

AdvaMed lobbied EPA chief Wheeler on cancer report amid delay in ethylene oxide regs

Group purchasing organizations working with hospitals are already seeing the impacts of the closure of ethylene oxide sterilization facilities, said David Gillan, senior vice president of sourcing operations at Vizient.

By David Lim • Nov. 25, 2019

Medical devices bigger culprit in antibiotic-resistant infections than surgical procedures, CDC analysis shows

Antibiotic resistance was higher in hospital-associated infections linked to use of devices like central lines, ventilators and urinary catheters, according to data collected from more than 5,600 sites between 2015 and 2017.​

By Susan Kelly • Nov. 25, 2019

Michigan focus of latest lawsuit over Medicaid work rules

It's the latest court protest of Medicaid work requirements in the nine states that obtained waivers. Most of the challenges have prevailed.

By Ron Shinkman • Nov. 25, 2019

Uncompensated care up significantly at US hospitals, led by Southeast

Smaller hospitals and those in states that did not expand Medicaid under the Affordable Care Act were most hit, according to a new survey.

By Ron Shinkman • Nov. 22, 2019

Trump FDA nominee Hahn advanced by Senate HELP Committee 18-5

Ranking Member Patty Murray said she would not support the nomination due to a lack of a commitment to back regulations to take flavored e-cigarettes that have not gone under FDA review off the market.

By David Lim • Updated Dec. 3, 2019

Under fire, Google defends Ascension data sharing project

Since "Project Nightingale" came to light last week, debate has raged over health data privacy. The reply from former Geisinger CEO David Feinberg comes as lawmakers seek more information.

By Shannon Muchmore • Nov. 21, 2019

Kentucky hospital pays $10M to resolve false claims, kickback allegations

The deal comes days after Sutter Health agreed to pay $30 million to settle claims it paid a group of cardiovascular surgeons in exchange for patient referrals and $15 million for other kickback and Medicare billing allegations. 

By Shannon Muchmore • Nov. 21, 2019

Medicare improper payment rate falling, but up in Medicaid, CHIP

For Medicare fee-for-service, the improper payment rate was at 7.25% last year, which CMS said is the lowest since 2010.

By Linda Wilson • Nov. 20, 2019

Providers take next step in social determinants: hyperlocalism

Industry can "help others have an uncomfortable dialogue about what is truly driving health outcomes in this country," Atrium Health's Alisahah Cole said at the Healthcare of Tomorrow conference.

By Shannon Muchmore • Nov. 19, 2019

Hospitals pledge to fight Trump admin price transparency plan in court

President Donald Trump said patients have "been getting ripped off for years" and HHS Secretary Alex Azar said the requirements are a "revolutionary" change for the industry.

By Samantha Liss , Shannon Muchmore • Nov. 18, 2019

FDA clears Pentax duodenoscope with disposable part in bid to cut infection risk

Center for Devices and Radiological Health Director Jeff Shuren called the clearance "another major step toward lowering the risk of infection among patients," and said duodenoscope safety is a top priority for the agency.

By David Lim • Nov. 18, 2019

IT execs call for HIPAA overhaul in 'Project Nightingale' wake

"People aren't doing anything against the law, but we're starting to think differently," Geisinger's chief informatics data officer said. "There's the legal court and then the court of public opinion, and that's starting to shift a little bit."

By Rebecca Pifer Parduhn • Nov. 18, 2019

JAMA: Lower cost hospitals have similar patient outcomes as higher cost counterparts

A new study in JAMA Network Open questions the assumption that patient acuity and case mix have as much of an impact on patient cost as the priciness of the individual hospital itself.

By Ron Shinkman • Nov. 15, 2019

HHS office awards $6M contract to improve antibiotic use

The contract will fund Inflammatix's efforts to distinguish between bacterial and viral infections, in a bid to limit overprescribing of antibiotics and the emergence of superbugs.

By Nick Paul Taylor • Nov. 15, 2019

Timeline of the Affordable Care Act — still under siege

A decision is expected any day on a lawsuit challenging the constitutionality of the ACA, a law that is no stranger to controversy and ire.​

By Shannon Muchmore , Samantha Liss • Nov. 13, 2019

CMS pitches ramped up oversight of Medicaid payments, promises block grant guidance

Provider lobbies clapped back Wednesday against the proposed rule, with America's Essential Hospitals calling it a "deeply damaging" policy that would erode state flexibility and the medical safety net.

By Rebecca Pifer Parduhn • Updated Nov. 13, 2019

Google's 'Project Nightingale' prompts HHS investigation

The Office of Civil Rights launched a federal inquiry into Google's R&D using the personal health information of tens of millions of patients from Ascension, the nation's second-largest health system.

By Rebecca Pifer Parduhn • Updated Nov. 13, 2019

Surprise billing services had higher-than-average markups

Annual price bumps were greatest at for-profit hospitals, those that served more uninsured patients (for emergency medicine services) and facilities in the Southeast, according to a research letter in JAMA Internal Medicine.​

By Shannon Muchmore • Nov. 11, 2019

From telehealth to 'Medicare for All': takeaways from HLTH19

All of Healthcare Dive's coverage from the health innovation conference's second year.

Nov. 8, 2019