Payer: Page 58
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E.A. Crunden/Healthcare Dive
House passes bill that would extend Medicare sequester cuts until December
The cuts will go back into effect March 31 and the bill now awaits action from the Senate. The hospital industry has been pushing hard for a delay.
By Hailey Mensik • March 19, 2021 -
Retrieved from C-SPAN on February 24, 2021
Becerra confirmed as HHS secretary
The 50-49 vote in the Senate was almost entirely along party lines. The only Republican to cross the aisle was Sen. Susan Collins of Maine.
By Shannon Muchmore • March 18, 2021 -
Explore the Trendline➔
Yujin Kim/Healthcare Dive
TrendlinePayer/provider relationships
As M&A intensifies and companies embrace more holistic and value-based care models, partnerships have become more closely intertwined.
By Healthcare Dive staff -
Permission granted by Health Affairs
Q&AHealth Affairs' Alan Weil reflects on 1 year of COVID-19
The editor in chief of the respected industry journal spoke with Healthcare Dive about the role of equity in health research, the staying power of telemedicine and how to effectively communicate important public health messages.
By Shannon Muchmore • March 18, 2021 -
MICHAEL PRINCE via Getty Images
CMS puts the brakes on breakthrough device coverage rule
The policy would automatically OK Medicare reimbursement for devices with FDA breakthrough status, but critics contend the rule would undermine CMS authority to consider the clinical evidence backing new technologies.
By Susan Kelly • March 17, 2021 -
Despite pandemic, MedPAC advises few changes to 2022 provider payments
To the extent that the effects of the crisis are temporary and vary significantly depending on provider, they're best addressed through targeted yet temporary funding policies, the congressional advisers said in an annual report.
By Rebecca Pifer • March 16, 2021 -
Courtesy of Walmart
CMS hikes COVID-19 vaccine pay, broadens scope of providers to give jab
The AMA praised the boosted reimbursement, intended to speed up distribution of the three currently available shots.
By Shannon Muchmore • March 16, 2021 -
Alex Wong via Getty Images
The top drugs that could be impacted by an obscure provision in the pandemic relief law
Elimination of the so-called penny rule in Medicaid could force drugmakers to pay larger rebates on a number of top medicines, including some HIV, diabetes and anti-inflammatory drugs.
By Jonathan Gardner • March 15, 2021 -
adeline kon/Healthcare Dive, data from Adeline Kon / Healthcare Dive
COVID-19: 1 year later
For the healthcare industry, much has changed, and some of those alterations may be permanent. Hope is beginning to bloom as three coronavirus vaccines have been authorized for emergency use in the U.S.
March 15, 2021 -
Ohio sues Centene, alleging PBM practices led to millions in overpayments
The payer called the claims "unfounded" in a statement, and said it planned to aggressively defend the integrity of its pharmacy services in Ohio.
By Rebecca Pifer • March 12, 2021 -
Deep DiveHospitals lift curtain on prices, revealing giant swings in pricing by procedure
The eye-popping variations demonstrate "the total insanity of American healthcare pricing," Niall Brennan, CEO of the Health Care Cost Institute, said.
By Samantha Liss , Nami Sumida • March 11, 2021 -
Alex Wong via Getty Images
CMS pushes back kidney care payment model start date to January 2022
It is the second Trump-era payment model President Joe Biden's health administration has recently tweaked.
By Rebecca Pifer • March 10, 2021 -
Countering payers, drugmakers say net prices declined in 2020
Reports from three large pharmaceutical companies indicate increasing rebate payments and discounts to insurers more than offset the average price increases they took on their medicines.
By Jonathan Gardner • March 8, 2021 -
COVID-19 among top US telehealth diagnoses for first time
Mental health conditions continue to be the No. 1 telehealth diagnosis nationwide, according to new data from nonprofit Fair Health.
By Rebecca Pifer • March 8, 2021 -
"Medical disposable masks on wooden background" by Marco Verch Professional Photographer and Speaker is licensed under CC BY 2.0
Becerra tells Californians to dispute COVID-19 fees from providers
Patients charged a "COVID fee" from a recent visit should contact their insurer and request a reimbursement, according to a statement from the state's attorney general, who is the nominee for HHS secretary.
By Hailey Mensik • March 4, 2021 -
Support for telehealth Medicare reimbursement gains steam in Congress
Tuesday's House committee mirrored similar Senate panels, in that a permanent expansion to a greater swath of the population enjoys bipartisan support, but legislators are split on what form it should take.
By Rebecca Pifer • March 3, 2021 -
Hillrom steps back from $375M BardyDx deal on reimbursement setback
The hospital products maker said a Medicare contractor's unexpected drop in payment rates for BardyDx's cardiac monitoring technology meant closing conditions for the transaction had not been satisfied.
By Susan Kelly • March 1, 2021 -
National Institute of Allergy and Infectious Diseases. (2020). "Novel Coronavirus SARS-CoV-2" [Micrograph]. Retrieved from Flickr.
CMS moves to stop COVID-19 testing denials, cost sharing in private plans
Congress required comprehensive health plans to cover COVID-19 tests without cost sharing, prior authorization or medical management last year, only for guidance to create uncertainty about the rules.
By Nick Paul Taylor • March 1, 2021 -
Permission granted by Cigna
Cigna health services arm Evernorth completes buy of telehealth vendor MDLive
The deal closed Monday, the payer said. MDLive will operate as part of Evernorth's portfolio that also includes pharmacy benefit manager Express Scripts.
By Rebecca Pifer • Updated April 20, 2021 -
Retrieved from The White House/YouTube on January 21, 2021
ACLA urges Biden to fund uninsured COVID-19 testing, close coverage loopholes
The plea from the trade group for Quest and LabCorp is the latest in a row between labs and insurers over paying for the diagnostics and comes as a $2 billion federal testing fund runs dry.
By Nick Paul Taylor • Feb. 24, 2021 -
SCOTUS drops Medicaid work requirement arguments at Biden administration's request
The administration is in the process of reversing the policy, which 12 states received federal approval to test. No such programs are currently active, having run into legal and administrative challenges even prior to the pandemic.
By Rebecca Pifer • Updated March 11, 2021 -
Oscar Health eyes $6.7B valuation with upcoming IPO
Even though the startup added members to plans and expanded to several states last year, it faces flagging financial performance that could tamp down investor enthusiasm.
By Rebecca Pifer • Feb. 22, 2021 -
Retrieved from Manatt on February 18, 2021
Obama admin alum Chiquita Brooks-LaSure picked to head CMS
Brooks-LaSure will have a lot on her plate. Biden during his campaign ran on expanding the role of the Affordable Care Act and perhaps attempting to build in a public option or lowered Medicare age eligibility.
By Shannon Muchmore • Updated Feb. 19, 2021 -
Anthem-backed digital startup Sharecare goes public in $3.9B blank check deal
The startup, launched by WebMD founder Jeff Arnold and medical TV personality Mehmet Oz, will merge with special purpose acquisition company Falcon Capital Acquisition and is the latest in the digital health SPAC craze.
By Rebecca Pifer • Feb. 17, 2021 -
Payer profits nosedived in Q4 on increased COVID-19 expenses
Still, major insurers ended 2020 in the black, buoyed by the pullback in utilization during earlier quarters.
Feb. 17, 2021 -
Biden admin begins plan to rescind Medicaid work mandates in win for providers
The policies threatened to lower hospitals' Medicaid revenues as enrollees lost coverage, raising uncompensated care costs. But lawsuits and the pandemic have kept states from implementing the controversial Trump-era requirements.
By Samantha Liss • Feb. 16, 2021
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