Government: Page 99
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Medicare drug rebate ban not magic balm, federal budget forecasters say
The Trump administration plan to eliminate certain drug rebates in Medicare would increase federal spending by $177 billion over a decade, the CBO found.
By Jonathan Gardner • May 3, 2019 -
CBO wades into 'Medicare for All' debate, sidesteps landmines for now
Providers and payers seized on the report to cement their opposition to single-payer policies, but the government agency avoided analysis of any specific plan.
By Tony Abraham • May 2, 2019 -
Trendline
Labor
Hospitals are navigating persistent labor shortages with the need to cut costs — a source of contention that could leave patients caught in the middle.
By Healthcare Dive staff -
AHA asks for antitrust probe of Centene-WellCare deal
While Centene CEO Michael Neidorff has downplayed antitrust concerns over the deal, he acknowledged to investors last week that divestitures are likely, specifically in Nebraska and Missouri.
By Shannon Muchmore • May 2, 2019 -
Trump administration asks appeals court to toss entire ACA
DOJ urged the Fifth Circuit to uphold a trial court's ruling finding the law unconstitutional, marking a change for the government, which had previously said the remainder of the ACA was severable from its individual mandate.
By Dana Elfin • May 2, 2019 -
CMS seeks comments on state workarounds to ACA requirements
The agency has gradually pushed states to consider more so-called innovation waivers that can allow them to sidestep key tenets of the ACA in their health insurance markets.
By Rebecca Pifer • May 2, 2019 -
CMS wants notice of ownership changes at accrediting organizations
The proposed rule follows the agency's drive to strengthen its oversight of accrediting organizations.
By Samantha Liss • April 30, 2019 -
More Medicaid insurers could be ticket to lowering premiums in ACA markets
An Urban Institute and Robert Wood Johnson Foundation report shows a correlation between states with lower premiums and broad Medicaid managed care coverage within the state.
By Meg Bryant • April 30, 2019 -
HHS curbs fines for HIPAA violations
A new legal interpretation of the act would cut the annual ceiling for a fine from $1.5 million and move to a tiered system, depending on violation severity.
By Rebecca Pifer • April 29, 2019 -
Deductibles soar in small business health insurance market
Small companies are turning to plans with restricted provider networks as a way to contain healthcare costs, insurance broker eHealth found.
By Les Masterson • April 29, 2019 -
ACA could cushion payers during next recession: Moody's
While health insurers wouldn't be able to avoid taking a hit from lower employment levels, the rating agency's research shows Medicaid expansions and the ACA exchanges create protections the companies didn't have in 2008.
By Tony Abraham • April 26, 2019 -
FTC accuses Surescripts of monopolizing e-prescribing markets
The commission alleges the health IT vendor, owned by some of the biggest PBMs and pharmacies, used exclusivity agreements and threats to stop customers from using other platforms.
By Shannon Muchmore • April 25, 2019 -
CMS urges state Medicaid programs to test new dual eligible care models
The agency lamented the lack of care coordination for the dual eligible population that leads to "misaligned incentives for payers and providers, and administrative inefficiencies and programmatic burdens for all."
By Les Masterson • April 25, 2019 -
Hospitals, doctors and Gawande laud new CMS primary care model, but will practices stay?
The agency set an ambitious goal of enrolling a quarter of all traditional Medicare fee-for-service providers and beneficiaries in the new model. The program, however, is voluntary, and some paths carry significant downside risk.​
By Shannon Muchmore • April 24, 2019 -
Medicare proposes raising CAR-T pay, but reimbursement solution years away
As new technologies nip at CAR-T's heels, CMS could take three years to develop a separate reimbursement category for Novartis' Kymriah and Gilead's Yescarta.
By Jonathan Gardner • April 24, 2019 -
CMS proposes wage index change to help prop up rural hospitals
The agency's proposed inpatient payment system rule would boost hospital Medicare payments by about 3.7%, which Jefferies noted was the largest increase in a decade.
By Tony Abraham • April 24, 2019 -
Half of middle-income seniors won't be able to afford healthcare, housing in a decade
Over the next decade, 60% of seniors will have mobility limitations and 20% will have high healthcare needs, according to a new study published in Health Affairs. And that's just the tip of the iceberg.
By Rebecca Pifer • April 24, 2019 -
Graying doctors, patients to fuel 122K physician shortage by 2032, AAMC warns
The Association of American Medical Colleges also notes that healthcare delivery trends such as better care coordination, value-based contracting and more advanced practice providers will cut demand for physicians by only 1%.
By Les Masterson • April 24, 2019 -
Data breach at physician staffing firm EmCare hits 31K patients
Unauthorized email access exposed patient, employee and contractor personal information, such as name, date of birth or age and patient clinical data, the company said.
By Les Masterson • April 23, 2019 -
CMS details new primary care payment model with range of risk options
The agency projects as many as a quarter of traditional Medicare fee-for-service beneficiaries will be incorporated into the voluntary five-year program, called Primary Cares Initiative.
By Shannon Muchmore • April 23, 2019 -
Medicare spending to snowball to 6% of GDP in next 2 decades, trustees predict
It's "striking" how Congress has ignored the warning signs of runaway spending, Paul Ginsburg, director of the USC-Brookings Schaeffer Initiative for Health Policy, told Healthcare Dive.
By Rebecca Pifer • April 23, 2019 -
Surprise billing, drug rebates among likely reforms this year, S&P Global says
ACA repeal efforts and "Medicare for All," however, have little chance of advancing in the current political landscape, according to a new report.
By Meg Bryant • April 22, 2019 -
CMS makes no change to silver loading, finalizes lower ACA exchange fees
The final rule for 2020 exchange plans also allows insurers to forgo applying drug manufacturer coupons toward patient out-of-pocket cost limits when a brand name drug has a generic alternative available.
By Shannon Muchmore • April 22, 2019 -
Fewer uninsured ED visits, hospitalizations after ACA, JAMA study finds
The report also credited recent trends like new payment models for the decrease, as well as growing hospital ED alternatives such as urgent care clinics, freestanding emergency rooms and telemedicine.
By Les Masterson • April 22, 2019 -
Hospital-led generic drug company Civica Rx opens headquarters
The company's opening comes after criticism of drugmakers and pharmacy benefit managers for price increases and generic drug shortages.
By Les Masterson • April 22, 2019 -
HHS drops 2nd TEFCA iteration, extends interoperability rules comment period
With three new TEFCA documents in addition to a facelift on the first draft, the government is narrowing a common set of data exchange principles for health IT providers and users to adopt.
By Rebecca Pifer • April 22, 2019