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CMS says it won't approve enhanced federal funding for partial Medicaid expansions

July 29, 2019


CMS last week rejected Utah's proposed Medicaid waiver request seeking enhanced federal funding for the state's partial Medicaid expansion, and the agency said it will not approve similar requests in the future.

How a first-of-its-kind bipartisan bill would address social determinants

July 29, 2019


A bipartisan group of House lawmakers on Thursday introduced a bill that would create a multi-agency council, as well as a $25 million federal fund, to address the social determinants of health.

Senate panel approves sweeping bill to lower Rx prices—but changes might be in store

July 26, 2019


The Senate Finance Committee on Thursday voted 19-9 to advance a bipartisan bill aimed at lowering prescription drug costs, but the bill might face opposition in the full Senate unless it undergoes substantial revisions.

Senate will take up 'surprise' billing package after August recess

July 26, 2019


The Senate Health, Education, Labor and Pensions Committee's top Republican and Democratic members on Wednesday said the full Senate would not take up the committee's legislative package to address so-called "surprise" medical bills before Congress' August recess.

The Trump admin's top 3 health care priorities

July 25, 2019


HHS Secretary Alex Azar on Tuesday laid out three of the Trump administration's top health care priorities heading into the 2020 election.

Inside the Senate Finance Committee's sweeping new proposal to lower Rx drug costs

July 24, 2019


Senate Finance Committee Chair Chuck Grassley (R-Iowa) and Sen. Ron Wyden (D-Ore.), the ranking member on the committee, on Tuesday introduced a sweeping bill aimed at lowering prescription drug costs by changing various Medicare and Medicaid policies, but the bill quickly drew criticism from congressional Republicans and the pharmaceutical industry.

Why lawmakers keep missing the biggest source of 'surprise' bills

July 24, 2019


At the state and federal levels, lawmakers are considering bills to address so-called "surprise" out-of-network medical bills, but their efforts largely ignore ground ambulances, which are one of the main sources of such bills.

How 'Dr. Dave' scammed insurers for $4M—without a medical license

July 23, 2019


For more than four years, a personal trainer who called himself "Dr. Dave" fraudulently billed major health insurers for about $25 million, collecting about $4 million in cash.

A physician's family couldn't find in-network care—and ended up with a $524K bill

July 23, 2019


When Sovereign Valentine learned he was in kidney failure and needed immediate dialysis, he and his wife, a physician at their local hospital, searched for an in-network facility to no avail. With no other options, Sovereign began dialysis at an out-of-network facility—and ended up with a $524,600.17 bill.

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