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CMS will allow MA plans to implement step-therapy requirements for Part B drugs

August 13, 2018


Under a new CMS policy, Medicare Advantage plans beginning Jan. 1, 2019, will be able to implement step-therapy requirements for prescription drugs administered to beneficiaries at physician offices or hospitals—and President Trump says his administration soon will announce more policies intended to lower prescription drug prices.

HHS announces recipients of Title X family planning grants

August 13, 2018


HHS says that it will award about $290 million in Title X family planning grants to all current grantees and 12 new organizations—including groups that are suing HHS over its new criteria for organizations seeking the grants.

This doctor wants to offer MRIs for as low as $500—but a state law is stopping him

August 3, 2018


After discovering an MRI would cost $1,200, Gajendra Singh, a gastroenterologist, decided to open his own imaging center in Winston-Salem, North Carolina, with MRI prices as low as $500—but a state law is proving to be a major obstacle.

Hospice has grown in popularity—and it's vulnerable to fraud, HHS' OIG finds

August 2, 2018


CMS says, "The agency takes the oversight role of the Medicare hospice program seriously and is aggressively focused on reducing and eliminating fraud, waste, and abuse."

Two states are looking to restructure exchange coverage. Here's how.

July 30, 2018


Alabama and Illinois so far are the only two states that have indicated they will seek CMS' permission to redefine the essential health benefits individual and small-group insurers in the states must cover for the 2020 coverage year, and the states appear to be approaching the changes in drastically different ways.

Verma says 'Medicare for All' would really mean 'Medicare for None'

July 27, 2018


CMS Administrator Seema Verma says Democrats' push to implement a so-called "Medicare for All" single-payer health system in the United States could undermine Medicare beneficiaries' care, but Sen. Bernie Sanders (I-Vt.) says, "Medicare has worked extremely well for our nation's seniors and will work equally well for all Americans."

What happens to ED patients when nurse staffing is low? A new study sheds light.

July 26, 2018


A new study provides evidence that lower nurse staffing leads to longer patient wait times and might threaten health care outcomes.

5.4M US residents have Alzheimer's. So why are clinical trials hurting for participants?

July 25, 2018


Scientists are having trouble finding patients to enroll in clinical trials for Alzheimer's disease treatments, even as researchers at the Alzheimer's Association International Conference say they have evidence that levels of female sex hormones can affect a woman's risk of Alzheimer's and other forms of dementia.

House passes bill to create three-digit dialing code for suicide prevention hotline

July 25, 2018


The bill would direct the Federal Communications Commission to work with HHS and Veterans Affairs to evaluate and report on the feasibility of establishing a new three-digit dialing code for the national mental health crisis and suicide prevention hotline, similar to how U.S. residents can dial 9-1-1 to be connected with emergency services.

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