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House passes bills to increase transparency around PBM rebates

October 31, 2019


The House on Monday voted unanimously to approve two bills that would increase transparency of the discounts drugmakers offer pharmacy benefit managers.

CMS launches window shopping ahead of 2020 open enrollment period

October 30, 2019


CMS last week opened window shopping for the Affordable Care Act's upcoming open enrollment period and detailed several changes the agency has made to HealthCare.gov.

Rep. Greg Walden is retiring. Here's what he's done on health care.

October 30, 2019


Rep. Greg Walden (Ore.), who since 2017 has served as the top Republican on the House Energy & Commerce Committee, on Monday announced that he will retire at the end of the current Congress and will not seek re-election.

New York's solution for 'surprise' medical bills is increasing health care costs, analysis finds

October 30, 2019


New York's arbitration process for addressing so-called "surprise" medical bills has resulted in higher payments to health care providers, and higher health care costs for state residents, according to an analysis released Thursday by the USC-Brookings Schaeffer Initiative for Health Policy.

Pelosi's Rx drug pricing bill might be unconstitutional, congressional researchers say

October 29, 2019


Provisions in House Speaker Nancy Pelosi's (D-Calif.) bill that aim to reduce prescription drug prices in the United States might violate the U.S. Constitution, according to a memo issued last week by Congressional Research Service that was obtained by news outlets.

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.

FDA approves new therapy to treat cystic fibrosis in patients 12 and older—and it will cost $311,503

October 28, 2019


FDA on Monday announced that it has approved Trikafta, the first-ever triple combination therapy to treat cystic fibrosis (CF) in patients ages 12 and older who have a genetic mutation that affects the vast majority of CF patients.

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.

Why a popular algorithm showed bias toward white patients (and how it can be fixed)

October 28, 2019


A widely used algorithm is more likely to classify white patients as needing follow-up care than comparably ill black patients, according to study in the journal Science—and the study's senior author said it is "inconceivable" that other common algorithms do not have similar flaws.

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.

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