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Senate's 'surprise billing' legislation would save $7.6B over 10 years, CBO predicts

July 18, 2019


The Senate Health, Education, Labor and Pensions Committee's legislative package to address out-of-network "surprise" medical bills would reduce average national provider payment rates by as much as 20%—with much of the effect due to a reduction in in-network payment rates, according to a Congressional Budget Office report released Tuesday.

As CMS tries to expand ACA waivers, Democrats look to scale them back

July 18, 2019


CMS on Monday released new resources for states seeking certain Affordable Care Act waivers, but Democrats have vowed to introduce legislation to roll back the Trump administration's criteria for the waivers after the Government Accountability Office determined Congress has the authority to overturn the guidance.

How WakeMed reduced heart surgery readmission rates by 30%

July 16, 2019


WakeMed Health & Hospitals pioneered the use of Enhanced Recovery After Surgery for heart surgery with dramatic results, seeing intensive care unit stays and readmissions fall and achieving estimated cost savings.

Biden just released his health reform plan. Here's what's inside.

July 15, 2019


Former Vice President Joe Biden, who is seeking the 2020 Democratic nomination for president, today unveiled a health reform plan that aims to build on and protect the Affordable Care Act by providing Americans with the option to enroll in a public health plan and expanding eligibility for subsidies to purchase exchange plans.

Inside the 346-page Home Health Prospective Payment System proposed rule

July 15, 2019


CMS on Thursday released a proposed rule to update certain Medicare payment regulations under the Home Health Prospective Payment System and increase payments for home health agencies by 1.3%.

CMS proposes mandatory bundled payment model for radiation oncology

July 12, 2019


CMS on Wednesday issued a proposed rule to implement a mandatory bundled payment model intended to replace Medicare's current fee-for-service payment model for radiation oncology in certain geographic regions.

Trump just pulled his proposal to eliminate Rx drug rebates. Here's why.

July 11, 2019


The Trump administration has withdrawn its proposed rule to prohibit drugmakers from paying rebates to pharmacy benefit managers under federal health programs, a White House spokesperson confirmed Wednesday.

In a first, California opens Medicaid to undocumented young adults

July 11, 2019


California Gov. Gavin Newsom (D) on Tuesday signed into law a state budget bill that will make California the first state in the country to open Medicaid eligibility in full to undocumented immigrants up through age 25.

How much do air ambulances charge private insurers? More than four times Medicare rates, study finds.

July 10, 2019


Charges for air ambulance services in 2016 were more than four times higher than the rate Medicare paid to transport patients via airplane or helicopter, according to a study recently published in Health Affairs.

Trump admin can't force drugmakers to reveal prices in TV ads, judge rules

July 9, 2019


A federal judge on Monday struck down HHS' final rule to require drugmakers to disclose their products' list prices in consumer-directed television advertisements, blocking the rule from taking effect on Tuesday.

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