Government
-
Deep Dive
California, Oregon eye universal health coverage
The states' proposals, which resemble Medicare for All, need approval from the federal government and face pushback from major health systems and insurers.
By John Canham-Clyne • April 24, 2024 -
Overturning of Roe v. Wade
HHS finalizes reproductive health data protections
HIPAA-covered entities will be barred from disclosing patient records on abortion, IVF or other reproductive healthcare that could be used in an investigation.
By Emily Olsen • April 23, 2024 -
Trendline
Social determinants of health
The focus on social determinants of health has only increased as the COVID-19 pandemic has devastated the United States.
By Healthcare Dive staff -
Nurse staffing rule slammed by both industry and advocacy groups
The rule places stricter staffing requirements on nursing homes than those initially proposed and offers exemptions for certain providers.
By Susanna Vogel • April 23, 2024 -
FTC votes to ban noncompetes, with far-reaching effects on doctors
The agency estimates the final rule would lower healthcare costs by $194 billion over the next decade, while freeing up physicians to more easily move between employers.
By Rebecca Pifer • April 23, 2024 -
Medicaid final rules hand hospitals win on supplemental payments
In two final rules issued Monday, the CMS also moved to crack down on financing gimmicks used by states and hospitals to increase federal Medicaid funding — though not until 2028.
By Rebecca Pifer • April 23, 2024 -
Novant, CHS fire back after FTC sues to block North Carolina hospital sale
The health systems resisted regulators’ allegations that the deal would stifle competition in the Charlotte area.
By Emily Olsen • April 19, 2024 -
Providers, drugmakers at odds over new 340B dispute resolution process
PhRMA said the new rule “panders to 340B hospitals,” while the American Hospital Association and 340B Health said the rule would preserve the drug discount program’s integrity.
By Rebecca Pifer • April 19, 2024 -
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 Rebecca Pifer • April 17, 2024 -
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 Emily Olsen • April 16, 2024 -
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 Emily Olsen • April 16, 2024 -
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 Emily Olsen • April 15, 2024 -
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 Rebecca Pifer • April 15, 2024 -
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 Emily Olsen • April 12, 2024 -
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 -
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 Rebecca Pifer • April 11, 2024 -
Tracking Steward's decline
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 Dive.
By Susanna Vogel • April 10, 2024 -
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 Rebecca Pifer • April 10, 2024 -
Michigan divvies out Medicaid contracts, with Centene, Molina seeing minor losses
However, the insurers could protest Michigan’s decision, potentially mitigating membership erosion.
By Rebecca Pifer • April 9, 2024 -
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 Susanna Vogel • April 9, 2024 -
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 Rebecca Pifer • April 8, 2024 -
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 -
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 Susanna Vogel • April 5, 2024 -
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 Rebecca Pifer • April 3, 2024 -
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 Rebecca Pifer • April 2, 2024 -
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