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Democratic debate round 3: Leading candidates still at odds over 'Medicare for All'

September 13, 2019


Democratic candidates vying for the 2020 presidential nomination sparred over health care in Thursday's primary debate, but did voters learn anything new?

VA must pay for non-VA emergency care even if veterans have other insurance, court rules

September 13, 2019


A federal appeals court this week ruled Veterans Affairs (VA) must reimburse veterans for emergency medical care provided at non-VA facilities—a decision that plaintiff's lawyers estimate could cost VA billions of dollars.

Insurers to pay a record $1.3B in rebates to consumers, employers under ACA

September 12, 2019


Health insurance companies this month are expected to begin paying an estimated $1.3 billion in rebates across the individual, small group, and large group insurance markets under the Affordable Care Act's medical loss ratio requirement, according to a Kaiser Family Foundation analysis published Tuesday.

How does Pelosi want to lower Rx prices? Leaked bill offers clues.

September 11, 2019


House Speaker Nancy Pelosi (D-Calif.) as early as this week could release a bill to tackle rising prescription drug costs—and a summary of the bill obtained by media outlets suggests Pelosi is considering allowing HHS to negotiate drug prices for certain treatments and establishing a drug price ceiling based on the prices paid for the drugs in other countries.

Groupon is now selling CT scans. Is that 'bonkers'?

September 11, 2019


As the debate around health care prices continues, some providers are turning to Groupon to get new patients in the door with deals on health care services—a trend that has persisted despite the industry's efforts to move away from volume-driven care.

How insurers are moving to cover multimillion-dollar gene therapies

September 9, 2019


Major insurers are eyeing and developing new strategies to help employers cover the cost of gene therapies priced at millions of dollars per treatment.

He died of an overdose—after $110,000 in substance use disorder treatment

September 6, 2019


Sean Blake died of a drug-related overdose in August 2017, after nearly a decade cycling in and out of substance use disorder (SUD) treatment programs that cost his family $110,000—a story that highlights the flaws in the U.S. SUD treatment system.

Medicare paid twice for about $161M in hospice drugs, report finds

September 5, 2019


Medicare Part D in 2016 unnecessarily spent an estimated $161 million on drugs that already were covered under Medicare Part A, according to an HHS Office of Inspector General report released last week.

Did California's provider payment rate-setting law work? It's complicated, research suggests.

September 5, 2019


A California law touted as a national model for addressing so-called "surprise" medical bills has led to fewer surprise bills for patients and lower payment rates for in-network and out-of-network physicians—but it might be driving physician group consolidation, according to recent research.

CMS rejects Idaho's proposal to limit voter-approved Medicaid expansion

September 4, 2019


CMS on Thursday rejected Idaho's request to expand the state's Medicaid program, but allow individuals who are eligible for the expanded program to remain enrolled in Affordable Care Act exchange plans.

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