Payer

Utah pauses Medicaid work requirements amid COVID-19

It was the only state running the controversial program that ties Medicaid eligibility to a certain number of work or volunteering hours.

By Rebecca Pifer • April 03, 2020

Health jobs plummeted in March despite rising need for healthcare workers

Dentist's offices shed 17,000 jobs, doctor's offices lost 12,000 and other healthcare practitioners lost 7,000 jobs, the Bureau of Labor Statistics reported Friday morning.

By Rebecca Pifer • April 03, 2020

How insurers are covering COVID-19

The Blue Cross Blue Shield Association and Molina became the latest payers to announce cost-sharing waivers for treating the novel coronavirus. Here's how the nation's largest insurers are responding to the pandemic.

By Samantha Liss • April 02, 2020

AHA wants private payers to do more to help hospitals fight COVID-19. Payers say they've done a lot already

"We are working hard to offer billions of dollars of additional resources and enhanced coverage," AHIP SVP of Communications Kristine Grow told Healthcare Dive. "But these resources are not infinite."

By Rebecca Pifer • April 02, 2020

Dorm rooms as hospitals, ER telehealth: CMS creates 'unprecedented' flexibility as COVID-19 rages on

Hospital groups on Tuesday applauded the actions from CMS, with the American Hospital Association calling the ability to care for patients outside of hospitals' four walls a "critical lifeline."

By Shannon Muchmore • UPDATED: April 1, 2020 at 9:12 a.m.

5 FDA approval decisions to watch in the 2nd quarter

The FDA's focus is squarely on responding to COVID-19, yet the agency continues to review new drugs for other diseases. Among them: Roche's SMA therapy risdiplam and Intercept's NASH drug.

By Jacob Bell , Ben Fidler • March 30, 2020

Humana, Cigna join Aetna in waiving COVID-19 treatment charges

CVS Health-owned Aetna first made the policy change Wednesday. Cigna is also deploying staff clinicians to assist its telehealth partner MDLive as more patients turn to virtual visits to avoid coronavirus exposure.

By Shannon Muchmore • March 30, 2020

Trump administration expedites Medicare payments to providers amid coronavirus

CMS advances Medicare payments in emergency situations like natural disasters or to address cash flow issues when there's a disruption in claims submission or processing, based on historical payments to a Medicare provider.

By Rebecca Pifer • March 30, 2020

DOJ sues Anthem for millions in overpayments related to MA plan members

The payer said it plans to vigorously defend its practices as the lawsuit alleges it put profits ahead of compliance.

By Samantha Liss • March 27, 2020

'What about us?': Frontline primary care practices fear for survival amid coronavirus

Independent practices have resisted selling to hospitals amid years of provider consolidation, reimbursement cuts and more, leaving them with razor-thin margins. Now, they worry COVID-19 could send them off the financial cliff.

By Rebecca Pifer • March 26, 2020

UnitedHealth says self-swabbing study spurred FDA coronavirus policy change

The agency now allows onsite self-collection of samples, after a nearly 500-patient study found self-administered tests about as accurate as those carried out by clinicians.

By Nick Paul Taylor • March 26, 2020

Coronavirus could hike premiums by double digits next year

Payers, smack dab in the middle of rate-setting for 2021, could increase premiums from 4% to more than 40% if they aim to recoup all COVID-19 costs and protect solvency, California actuaries say.

By Rebecca Pifer • March 25, 2020

As Congress gains ground on stimulus, healthcare workers ask people to stay home

President Donald Trump, however, said he wanted the nation to be "opened up" by Easter, despite strong advice from public health experts that the U.S. continue social distancing efforts.

By Shannon Muchmore • March 25, 2020

Nearly 2 dozen states now have Medicaid waivers for coronavirus response

The waivers allow suspension of federal regulations surrounding prior authorization, sites of care and physician enrollment, among others.

By Rebecca Pifer • UPDATED: March 26, 2020 at 10:11 a.m.

On 10th anniversary, embattled Affordable Care Act faces yet another stress test

The law now faces a significant test as the nation likely heads into a recession amid the novel coronavirus pandemic, straining the health system in an unprecedented way.

Hard-hit Washington state gets CMS green light for Medicaid coronavirus waiver

The Trump administration did not approve a request to expand Medicaid to a greater number of uninsured residents in the state.

By Rebecca Pifer • March 20, 2020

Telehealth payment parity in Medicare welcome, but some vendors say it should have come sooner

"We've all been preparing for this and we certainly anticipated this was going to happen," Doctor on Demand's chief legal and business affairs officer told Healthcare Dive.

By Rebecca Pifer • March 19, 2020

Value-based payment models take hold in medtech, but barriers slow shift

The arrangements are becoming more prevalent, especially for costly devices used in chronic disease management and in hospital settings, according to a recent Deloitte report.

By Susan Kelly • March 18, 2020

Medicare will now cover telehealth to fight coronavirus

It's a move telemedicine companies like Teladoc and American Well have been requesting since well before the outbreak, but the change is scheduled to be in place only for as long as the national emergency is designated.

By Rebecca Pifer • March 17, 2020

Trump administration approves 1st Medicaid waiver to combat coronavirus

Florida was the first state to submit a section 1135 waiver in response to the national emergency, but it's unlikely to be the last as the country grapples with its response to the virus.

By Rebecca Pifer • March 17, 2020

COVID-19 puts unprecedented strain on US health system

Some Providence hospitals are converting operating rooms to intensive care units to prepare for a surge in coronavirus patients as federal officials pleaded with the American public to avoid gathering in groups.

As coronavirus threatens hospital capacity, debate swirls around elective procedures

The Senate is expected this week to take up a House-passed relief package that includes a 6.2 percentage point hike to the federal Medicaid matching rate, a move backed by providers.

By Shannon Muchmore • March 16, 2020

MedPAC suggests targeted increase in hospital rates

The commission's annual March report to Congress also showed Medicare Advantage enrollment continues to increase, with a 10% jump from 2018 to 2019.

By Shannon Muchmore • March 13, 2020

As US officials shift tone, Trump stops short of 1 provider ask

The president addressed the nation Wednesday night but did not declare a disaster or national emergency, which groups like the American Hospital Association had sought.

By Samantha Liss , Shannon Muchmore • March 12, 2020

Controversial EHR mandate in interoperability rule could threaten hospital Medicare reimbursement

The new requirement that hospitals must send electronic notice of key changes in a patient's status is worrying some facilities, especially those in rural areas and treating a high proportion of low-income patients.

By Rebecca Pifer • March 12, 2020