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Medicare wants to revamp ambulance payments, aiming to prevent avoidable ED visits

February 15, 2019


HHS on Thursday announced the launch of a new voluntary payment model for emergency ambulance services—called the Emergency Triage, Treat, and Transport (ET3) model—that would allow Medicare to reimburse first responders for care delivered on-site or via telemedicine, even if patients are not taken to a hospital.

In the states: Georgia seeks partial Medicaid expansion, Maine co-op asks SCOTUS to hear case on risk corridor payments, and more

February 15, 2019


American Health Line rounds up the latest health care news in the states.

As the US uninsured rate declined, more adults became underinsured, survey finds

February 7, 2019


The U.S. uninsured rate has declined since the Affordable Care Act took effect in 2010, but the percentage of underinsured U.S. adults has grown, according to a survey brief from the Commonwealth Fund released Thursday. See the trends, charted.

These 6 senators are asking hard questions about 'surprise' medical bills

February 7, 2019


A bipartisan group of senators this week sent letters to health care providers and insurers to learn more about their out-of-network billing and payment practices—a step toward potential legislation to rein in so-called "surprise" medical bills.

There's 'no evidence' that HRRP increases patient deaths, former Obama official contends

February 4, 2019


Weighing in on a heated controversy over the Hospital Readmissions Reduction Program (HRRP), Peter Orszag—who was director of the Office of Management and Budget when HRRP was created—argues in NEJM Catalyst that HRRP has "either no effect or a beneficial one on mortality."

HHS just released its long-anticipated proposed rule on PBM rebates. Here's what's inside.

February 1, 2019


HHS on Thursday released a proposed rule aimed at lowering prescription drug prices by revising federal protections that currently allow drug manufacturers to pay rebates to Medicare Part D plans, Medicaid managed care plans, and pharmacy benefit managers.

CMS' top 3 priorities for 2019, according to Verma

January 31, 2019


CMS Administrator Seema Verma on Tuesday said the agency in 2019 will focus on rural health care provider payments, encouraging more providers to enter value-based payment models, and advancing the use of technology in Medicare.

CMS wants to raise MA payments, expand benefits in 2020

January 31, 2019


CMS on Wednesday released an advance notice of proposed changes for Medicare Advantage (MA) plans, which includes proposals to increase baseline payment rates for MA plans, lower cost-sharing requirements for some chronic pain treatments, and offer targeted benefits to improve the health of chronically ill beneficiaries.

Congress kicks off hearings on Rx drug prices, other health issues

January 30, 2019


Committees in the Senate and House on Tuesday began a series of hearings focused on health care issues, including prescription drug prices, protections for U.S. residents with pre-existing medical conditions, and health insurance options.

Inside the first criminal trial alleging pharma execs played a role in the opioid epidemic

January 30, 2019


A federal prosecutor on Monday accused former Insys Therapeutics CEO John Kapoor and four of the company's other executives of contributing to the U.S. opioid epidemic by using illegal marketing tactics to drive up sales of the opioid drug Subsys—but Beth Wilkinson, a lawyer representing Kapoor, says the charges are "patently false."

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