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Inside the Senate Finance Committee's sweeping new proposal to lower Rx drug costs

July 24, 2019


Senate Finance Committee Chair Chuck Grassley (R-Iowa) and Sen. Ron Wyden (D-Ore.), the ranking member on the committee, on Tuesday introduced a sweeping bill aimed at lowering prescription drug costs by changing various Medicare and Medicaid policies, but the bill quickly drew criticism from congressional Republicans and the pharmaceutical industry.

What's more accurate than health plan directories? Google, a study finds.

July 24, 2019


Google offers more accurate provider information than many health plan directories, such as health plans' Medicare Advantage directories and exchange plan directories, according to a study recently published in the American Journal of Managed Care.

How 'Dr. Dave' scammed insurers for $4M—without a medical license

July 23, 2019


For more than four years, a personal trainer who called himself "Dr. Dave" fraudulently billed major health insurers for about $25 million, collecting about $4 million in cash.

Verma calls public option proposals a single-payer 'Trojan horse'

July 23, 2019


CMS Administrator Seema Verma on Monday criticized proposals to implement a so-called "public option" health plan in the United States, calling such a plan a "Trojan horse with a single-payer hiding inside."

Medicare has overpaid MA insurers billions. Now, CMS wants the payments back.

July 22, 2019


CMS is preparing to move forward with a proposal to use audits to recoup millions of dollars in overpayments to Medicare Advantage insurers, after insurers overcharged Medicare by nearly $30 billion over the past three years.

CMS penalties aren't lowering hospital-acquired conditions, study suggests

July 22, 2019


Penalties levied under CMS' Hospital-Acquired Condition (HAC) Reduction Program are not leading to lower rates of HACs at penalized hospitals when compared with non-penalized hospitals, according to a study recently published in The BMJ.

Fewer ACOS joined MSSP in 2019—but more are taking on risk, data show

July 19, 2019


Fewer accountable care organizations (ACOs) joined the Medicare Shared Savings Program in 2019 than in 2018—but more ACOs are taking on financial risk than in previous years, CMS Administrator Seema Verma announced in a Health Affairs blog published Wednesday.

Sanders to propose $20B fund aimed at stemming hospital closures

July 18, 2019


Sen. Bernie Sanders (I-Vt.), who is seeking the 2020 Democratic nomination for president, on Monday announced that he plans to introduce legislation to establish a federal fund to help local governments buy for-profit hospitals at risk of closing.

Fortune's '40 under 40': The 19 health care trailblazers who made the list

July 17, 2019


Fortune last week released its "40 under 40" list of the most influential "entrepreneurs, leaders, and iconoclasts" under 40 years old, including 19 who are known for their contributions to the health care and wellness industries.

MACRA's Advanced APM track attracted more clinicians in 2018, CMS says

July 17, 2019


The number of clinicians who participated in MACRA's Advanced Alternative Payment Model track increased from 2017 to 2018, while the number of clinicians who participated in MACRA's Merit-based Incentive Payment System decreased, according to preliminary data CMS released Thursday.

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