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Judge: HHS must pay insurers $1.6B in ACA payments

October 28, 2019


A federal judge on Tuesday ordered the federal government to reimburse nearly 100 health insurers about $1.6 billion in unpaid cost-sharing reduction payments called for under the Affordable Care Act.

The 5 keys to value-based care, according to Intermountain CEO Marc Harrison

October 28, 2019


As the health care industry moves toward value-based payment models, Intermountain Healthcare President and CEO Marc Harrison writing in Harvard Business Review offers his five principles to implementing a successful value-based care program.

CMS delays new primary care, kidney care value-based payment models

October 28, 2019


CMS on Thursday announced it is delaying the start of several new voluntary value-based payment models, but it continued to encourage Medicare providers to apply to participate in the payment models.

Final committee OK's Pelosi's Rx drug pricing bill

October 24, 2019


The House Ways & Means Committee on Tuesday voted 24-17 to approve House Speaker Nancy Pelosi's (D-Calif.) bill that aims to reduce prescription drug prices in the United States, sending the measure to the full House for a potential floor vote.

Judge denies CMS' request to stay ruling striking down site-neutral payments

October 23, 2019


A federal judge on Monday denied CMS' request to modify and stay a prior ruling that struck down cuts to Medicare payment rates for off-campus hospital facilities.

State AGs announce settlement framework that could resolve thousands of opioid lawsuits

October 22, 2019


Attorneys general from four states on Monday released a framework for a $48 billion agreement with three of the United States' largest drug distributors and other pharmaceutical companies that could settle thousands of lawsuits claiming the companies fueled the opioid epidemic.

Why some Native American tribes are breaking with Indian Health Service

October 22, 2019


A growing number of Native American tribes are taking control of troubled government-run hospitals in an effort to improve care for their communities, but some are finding the turnaround is both slow and costly.

Investigation: 700+ physicians were paid over $1M by drugmakers, device makers

October 21, 2019


Drugmakers and medical device makers paid more than 700 physicians at least $1 million each in the past four years, according to an analysis of CMS' Open Payments database released by ProPublica last week.

Should hospitals help a patient regain mobility—or protect them from falls? Sometimes, it's a tough choice.

October 15, 2019


Falls are the leading cause of fatal and nonfatal injuries for older Americans, but hospitals seeking to prevent falls are facing a conundrum over whether patients should remain bedbound to avoid dangers or move to regain their mobility.

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