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How these top-ranking lawmakers want to stop 'surprise' medical bills

May 15, 2019

The highest-ranking Democrat and Republican on the House Energy and Commerce Committee on Tuesday released a draft bill to address so-called "surprise" medical bills by setting a benchmark payment rate for out-of-network services—a proposal health care providers have said they oppose.

Hospitals are paid twice as much (or more) by private insurers than Medicare, study finds

May 13, 2019

Employer-sponsored private health plans in 2017 paid more than double the amount Medicare paid for identical health care services, according to a report from RAND released Thursday.

When a 'John Doe' enters the ED, a high-stakes game of detective begins

May 13, 2019

Hospital staff must do a bit of sleuthing when unidentified patients arrive at the emergency department, all while providing care without the patients' medical histories.

Insurers set to repay customers a record $800M in rebates, KFF predicts

May 10, 2019

Individual market insurers in 2018 had their best year since 2011, and they are projected to have to pay back a record-setting $800 million in rebates to enrollees, according to a Kaiser Family Foundation analysis published Tuesday.

For the first time, employed physicians outnumber independent physicians, AMA finds

May 9, 2019

Employed physicians outnumbered self-employed physicians in the United States for the first time in 2018, according to an updated American Medical Association study released Monday.

Judge orders HHS to remedy $1.6B in unlawful 340B cuts

May 9, 2019

A federal judge on Monday ordered HHS to come up with a remedial measure that would address hospital payment cuts under Medicare's 340B drug discount program for 2018 and 2019, which the judge previously ruled were unlawful.

Is the federal government overpaying MA plans? Yes, a new study suggests.

May 8, 2019

CMS could be overpaying Medicare Advantage (MA) plans by billions of dollars because of how it calculates MA payment rates, according to Kaiser Family Foundation analysis released Tuesday.

CMS finalizes rule to stop states from diverting Medicaid payments to third parties

May 7, 2019

CMS on Thursday finalized a rule that intends to stop states from diverting Medicaid payments to third parties, with certain exceptions.

Tennessee could become first state to ask CMS for Medicaid block grants

May 6, 2019

Tennessee's Legislature on Thursday approved a bill that directs state officials to ask the federal government to distribute the state's federal Medicaid funding in the form of a block grant, and in exchange give the state additional flexibility over how it administers its Medicaid program.

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