Payer: Page 92
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MedPAC urges MA data, primary care reforms
Included in the recommendations to Congress are changes to slow the growth of ER spending in Medicare fee-for-service.
By Samantha Liss • June 14, 2019 -
Getty / Edited by BioPharma Dive
Bluebird sets $1.8M price tag for blood-disease gene therapy
Payers around the world are grappling with the launch of gene therapies, many of which promise one-time treatments that can avert long-term healthcare costs.
By Jonathan Gardner • June 14, 2019 -
CMS warned Trump policies would hike taxes, cause ACA disruption, internal memo says
Democratic leaders on the House Energy and Commerce Committee sent a letter Friday to HHS Secretary Alex Azar inquiring into the harmful effects of administration policies in light of what they called "damning" evidence.
By Rebecca Pifer Parduhn • June 14, 2019 -
Florida health insurer sued over skimpy plans
The defendant, Health Insurance Innovations, is one of the 12 companies under investigation by the House Committee on Energy and Commerce for their work in pushing the plans to consumers.
By Rebecca Pifer Parduhn • June 13, 2019 -
Payers, providers dig in on surprise billing proposals
Industry groups are testifying on the issue before Congress again Wednesday at the third hearing in as many months.
By Shannon Muchmore • June 12, 2019 -
Influential panel urges HIV prevention drug, forcing payer hands
The task force charged with making clinical recommendations is advising those at high risk of contracting HIV take a daily medication to prevent the disease, which will likely expand access to the treatment.
By Samantha Liss • June 12, 2019 -
AMA affirms opposition to single-payer in close vote
Other proposals the physician group adopted encourage a focus on vulnerable patients in alternative payment models, more scrutiny on pharmacy benefit managers' role in the drug supply chain and tweaks to the Affordable Care Act.
By Shannon Muchmore • June 12, 2019 -
Congress warns industry to hurry on surprise billing fix
"If you don't solve the problem, then we will solve the problem and none of you will like it," Rep. Michael Burgess, R-Texas, told payer and provider reps testifying Wednesday.
By Rebecca Pifer Parduhn • June 12, 2019 -
Humana integrating real-time benefit check into Epic EHRs
"Not all EMR companies are created equal," Humana's president of retail told Healthcare Dive, but the insurer plans to collaborate with other health IT vendors on data sharing projects.
By Rebecca Pifer Parduhn • Updated June 12, 2019 -
CVS Caremark service aims to help employers manage nontraditional benefit options
The move by the pharmacy benefits manager comes as employers and payers increasingly offer to cover digital health tools to track nutrition, exercise and sleep.
By Samantha Liss • June 11, 2019 -
Are teaching hospitals more expensive? A new JAMA study may surprise some
When comparing the total cost of care at 30 days for one episode, starting with hospitalization, researchers found major teaching hospitals were less expensive compared with nonteaching hospitals.
By Samantha Liss • June 10, 2019 -
Quest, LabCorp breach stirs questions of cybersecurity risk from outside vendors
The breach could result in new regulations and rules governing how U.S. companies select and assess their vendors, according to Moody's Investor Service.
By Rebecca Pifer Parduhn • June 10, 2019 -
Getty / Edited by BioPharma Dive
Deep Dive
The gene therapy era has arrived. So have the challenges.
The chief medical officer for Harvard Pilgrim Health Care said Medicaid pricing law needs to change to enable flexibility for payers as they navigate a world with $2.1 million treatments.
By Andrew Dunn • June 10, 2019 -
Industry balks at Senate proposals to boost competition, price transparency
Employers and health policy experts argued banning certain contract clauses and making more information available to consumers would benefit patients in comments to the Senate HELP committee this week.
By Shannon Muchmore • June 7, 2019 -
Medicare beneficiaries prefer traditional over MA in 1st eligible year
A majority of new Medicare beneficiaries continue to opt into traditional plans over Medicare Advantage, suggesting the buzz around MA may be exaggerated, according to a Kaiser Family Foundation study.
By Rebecca Pifer Parduhn • June 7, 2019 -
Price transparency proposals raise thorny questions
One hospital CEO is bucking the trend and embracing price disclosure, but the effectiveness of such requirements is unclear.
By Samantha Liss • June 7, 2019 -
CMS calls for ideas to cut red tape
Federal health regulators want to reduce the administrative burden and "needless paperwork" baked in the system and they're asking the public to submit ideas.
By Samantha Liss • June 7, 2019 -
Judge, CVS witness clash on merger settlement, July hearing set
Federal Judge Richard Leon told lawyers they might want to cancel their summer vacation plans as he voiced concern about the leverage the merged health giant will wield in the marketplace.
By Dana Elfin • June 6, 2019 -
Americans want their doctors to ask about social needs
A national survey conducted by Kaiser Permanente revealed that 74% of Americans are frequently stressed over meeting the needs of their families when it comes food and housing.
By Samantha Liss • June 5, 2019 -
Enrollment in standalone Medicare Part D plans drops slightly
The decline marks the first dip since the program's inception in 2006, according to a new report from the Kaiser Family Foundation.
By Samantha Liss • June 5, 2019 -
AMA witness tells judge CVS-Aetna merger creates significant competitive concerns
The judge determining the adequacy of the CVS-Aetna merger settlement with the government asked the witness whether he should go beyond the union's effects in the Medicare Part D market.
By Dana Elfin • June 4, 2019 -
CVS to open 1.5K HealthHUB stores in next 2 years
The pharmacy chain's shares were up 3% premarket Tuesday following the news, which was released in tandem with the company's 2019 Investor Day.
By Rebecca Pifer Parduhn • June 4, 2019 -
Utah wants capped Medicaid enrollment, spending
In a new demonstration waiver, the state proposes capping the growth rate of federal payments for its limited Medicaid expansion at the rate of medical inflation, rather than the usual, lower rate of consumer price inflation.
By Rebecca Pifer Parduhn • June 3, 2019 -
ONC exploring ways to streamline electronic prior authorization
The HHS IT chief criticized the current state of electronic prior authorization at Academy Health's conference Monday, calling it a "non-computerized kabuki of payment" that "needs to get rethought."
By Rebecca Pifer Parduhn • June 3, 2019 -
What's at stake in CVS-Aetna merger hearing: 4 questions
Judge Richard Leon will hear testimony from proponents and opponents of DOJ's settlement agreement with CVS and Aetna at what is shaping up to be a contentious hearing starting Tuesday in federal court.
By Dana Elfin • June 3, 2019
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