Government


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    ACOs led by independent physicians save Medicare ‘substantially’ more money, CBO says

    Independent practices have clearer financial incentives to lower medical spending than hospitals participating in accountable care organizations, according to the Congressional Budget Office.

    By April 17, 2024
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    Change Healthcare cyberattack

    Lawmakers raise healthcare consolidation concerns after Change cyberattack

    Legislators also slammed UnitedHealth Group, which acquired Change Healthcare nearly two years ago, for not sending a representative to the House subcommittee hearing.

    By April 16, 2024
  • Trendline

    Labor

    Disputes between hospitals and workers are likely to continue even as the pandemic’s greatest impacts subside — a source of friction that could leave patients caught in the middle.

    By Healthcare Blog staff
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    Telehealth company Cerebral to pay $7M fine over data sharing

    The Federal Trade Commission alleged the digital mental healthcare company had provided sensitive data to third parties and maintained “sloppy” security practices.

    By April 16, 2024
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    VA plans to resume Oracle EHR rollout by end of FY 2025, secretary says

    The agency needs a single electronic health record that’s more interoperable with the Department of Defense, VA Secretary Denis McDonough told lawmakers.

    By April 15, 2024
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    Florida issues Medicaid managed care awards booting out UnitedHealth, CVS and Molina

    Meanwhile, Centene, Elevance and Humana held onto statewide contracts. The reprocurement was especially positive for Centene, which had been expected to lose market share, analysts said.

    By April 15, 2024
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    Medicaid redeterminations

    More than 20M disenrolled amid Medicaid redeterminations

    Nearly a quarter of adults removed from the safety-net program since early last year said they are uninsured, according to KFF.

    By April 12, 2024
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    Regeneron
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    US sues Regeneron, alleging false price reporting on Eylea

    The Department of Justice accused Regeneron of defrauding Medicare by knowingly inflating the average sales price for its top-selling eye drug.

    By Kristin Jensen • April 11, 2024
  • The HHS in DC
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    CMS proposes 2.6% payment increase for inpatient hospitals next year

    Regulators said payments to hospitals would increase $3.2 billion in 2025 under the proposed rule. However, the American Hospital Association called the hike “woefully inadequate.”

    By April 11, 2024
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    Massachusetts lawmakers call on regulators to review Steward-UnitedHealth deal

    Antitrust agencies could be sympathetic toward the deal, given Steward’s financial distress and important hospital portfolio. But sympathy won’t shield the deal from scrutiny, an expert told Healthcare Blog.

    By April 10, 2024
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    Confusion about Medicaid skewing coverage estimates, study finds

    The number of people enrolled in Medicaid soared over the pandemic, but many enrollees may not have known their coverage had continued, new research suggests.

    By April 10, 2024
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    Michigan divvies out Medicaid contracts, with Centene, Molina seeing minor losses

    However, the insurers could protest Michigan’s decision, potentially mitigating membership erosion.

    By April 9, 2024
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    North Carolina county seeks damages in HCA Mission lawsuit

    Buncombe County is seeking to join a lawsuit from the state alleging HCA intentionally understaffed Mission’s emergency department, increased wait times and wasted taxpayer dollars.

    By April 9, 2024
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    CMS caps broker payments in Medicare Advantage

    The final rule issued last week prevents insurers from paying brokers additional fees for steering beneficiaries to their plans.

    By April 8, 2024
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    Physicians ask FDA to revoke approval of DNA test for opioid addiction

    Providers said the test is based “on old genetic studies that have largely been abandoned” and could exacerbate the opioid crisis.

    By Nick Paul Taylor • April 8, 2024
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    Senate ramps up scrutiny of private equity ‘greed’ in healthcare

    As private equity firms buy up hospitals and staffing agencies, lawmakers say they're increasingly concerned that patient care could suffer.

    By April 5, 2024
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    CMS finalizes ACA network adequacy rule

    Starting in 2026, plans sold in state-based exchanges will be required to meet time and distance standards for provider access that are already applied to plans sold federally.

    By April 3, 2024
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    Biden administration finalizes modest cut to 2025 Medicare Advantage rates

    Despite heavy lobbying, insurers failed to see MA rates improve in the final rule, which codified a 0.16% decrease to benchmark funding.

    By April 2, 2024
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    School-based Medicaid billing concerns delay proposed rule

    Concerns over negative impacts to students’ out-of-school public insurance benefits appear to be delaying the release of a federal education rule.

    By Kara Arundel • April 2, 2024
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    Biden administration finalizes rule cracking down on short-term plans

    Democrat lawmakers and patient advocacy groups cheered the final rule for protecting patients from the skimpy plans, while free-market advocates slammed it as limiting coverage options for consumers.

    By March 29, 2024
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    New federal health IT strategy increases focus on public health, AI

    The draft plan builds on its predecessor, which the health IT agency said drove “significant progress” in the use and exchange of electronic health information.

    By March 28, 2024
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    CMS streamlines Medicaid, CHIP renewal and enrollment in final rule

    It’s the “most robust and meaningful” regulation streamlining Medicaid eligibility since the Affordable Care Act was implemented a decade ago, one lawyer said.

    By March 28, 2024
  • People gather outside the U.S. Supreme Court in Washington, D.C. on Friday, April 21.
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    Michaela Wong/Healthcare Blog
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    Overturning of Roe v. Wade

    Supreme Court weighs abortion opponents’ standing in mifepristone case

    Reversal of the FDA’s expanded access could limit use of medication abortion even in states that have legal protections for the procedure in place.

    By March 27, 2024
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    Medicare’s GLP-1 spending is skyrocketing, even without weight loss coverage: KFF

    Gross Medicare spending on the pricey drugs rose from $57 million in 2018 to $5.7 billion in 2022, according to a new analysis from the health policy group.

    By March 27, 2024
  • Rep. Jamie Raskin
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    Change Healthcare cyberattack

    Senior lawmaker questions UnitedHealth over Change cyberattack

    Rep. Jamie Raskin, D-Md., said UnitedHealth’s “rapid consolidation and vertical integration” has major consequences for the healthcare sector, including increased control of the health IT market.

    By March 26, 2024
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    OIG details errors with VA, Oracle EHR deployment

    Three reports released last week outline scheduling and pharmacy problems with the electronic health record integration — including an error that may have contributed to a patient’s death.

    By March 25, 2024