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Are these 5 types of medical billing 'fraud by any other name'?

December 13, 2019


Elisabeth Rosenthal, a physician and editor-in-chief of Kaiser Health News, in a New York Times opinion piece recalls her husband's recent experience navigating the U.S. health care system and argues that "[m]uch of what we accept as legal in medical billing would be regarded as fraud in any other sector."

CBO: Pelosi's Rx drug pricing bill would save feds a net $5B—and slow down drug development

December 12, 2019


A provision in House Speaker Nancy Pelosi's (D-Calif.) drug pricing bill that would allow the HHS secretary to negotiate prescription drug prices would save the federal government about $456 billion from 2020-2029, but the bill would raise federal spending in other areas, according a Congressional Budget Office report released Tuesday.

SCOTUS hears arguments in ACA risk corridors case

December 12, 2019


The Supreme Court on Tuesday heard oral arguments in a case that centers on whether the federal government owes health insurers $12 billion in risk corridors payments under the Affordable Care Act, and observers say a majority of the justices appeared likely to rule in the insurers' favor.

The House has another new proposal to address 'surprise' medical bills

December 12, 2019


The House Ways and Means Committee on Wednesday announced new legislation, which is still being finalized, to address so-called "surprise" medical bills—just days after the Senate Health, Education, Labor and Pensions Committee and the House Energy and Commerce Committee announced their own bipartisan plan to address surprise bills, likely setting up Congress to resolve the issue in 2020.

Lawmakers could be headed for a showdown on Rx drug prices

December 10, 2019


Leaders on the Senate Finance Committee on Friday unveiled a new, bipartisan bill intended to lower prescription drug prices, and House Republicans on Monday announced a similar bill—both of which clash with a separate proposal introduced earlier this year by House Speaker Nancy Pelosi (D-Calif.).

With opposition from industry, the future of surprise billing legislation remains uncertain

December 10, 2019


The White House on Monday expressed support for a new, bipartisan agreement to address so-called "surprise" medical bills, but the proposal's future is uncertain, as it faces opposition from the provider industry and has yet to receive an endorsement from congressional leadership.

Senate, House lawmakers announce a deal to fix 'surprise' medical bills

December 9, 2019


Three federal lawmakers on Sunday announced that the Senate Health, Education, Labor and Pensions Committee and the House Energy and Commerce Committee have reached a bipartisan agreement in principle on legislation to address so-called "surprise" medical bills that could be attached to a year-end spending bill.

How much would a 'public option' disrupt health care? More than you might think.

December 6, 2019


In the Democratic presidential debates, public option health plans are being positioned as more "moderate" and less "disruptive" alternatives to single-payer proposals, such as Medicare for All—but what is lost in that framing is just how much public option plans would disrupt the current system, Margot Sanger-Katz writes for the New York Times' "The Upshot."

Why 541 local governments are ditching the class settlement to resolve opioid lawsuits

December 5, 2019


Hundreds of local governments in regions of the United States most affected by the opioid epidemic have opted out of participating in a novel legal mechanism designed to settle thousands of lawsuits that claim drug distributors and manufacturers fueled the opioid crisis, according to court filings released Monday.

Bad debt is rising again at nonprofit hospitals, Moody's finds

December 2, 2019


The amount of bad debt nonprofit hospitals experience increased in 2018 for the first time since 2014, in part because of changes to insurance benefit designs that are placing greater financial responsibility on patients, according to a new report from Moody's Investors Service.

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