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Department of Health and Human Services (HHS) Secretary Xavier Becerra renewed Wednesday the COVID-19 public health emergency (PHE) for another 90 days, extending with it key waivers and regulatory | HHS Secretary Xavier Becerra has extended the COVID-19 public health emergency again for another 90 days and possibly for the last time. → Read More
The Biden administration released a proposal to streamline Medicare Advantage (MA) and Part D plan prior authorization and add health equity requirements to star ratings. | CMS proposed new policies for Medicare Advantage and Part D plans, including streamlining prior authorization and adding a health equity index to star ratings. → Read More
A new bipartisan Senate bill aims to extend for two years a 5% bonus to doctors who participate in alternative payment models, with lawmakers having little time to get it through Congress before th | A new bipartisan Senate bill seeks to extend by two years a 5% bonus payment to physicians that sign up for an alternative payment model. → Read More
Cigna and its pharmacy benefit manager subsidiary Express Scripts should roll back a decision to shrink by 13,000 the pharmacy network for TRICARE, which offers coverage for active-duty military me | Several pharmacy groups are slamming Cigna and Express Scripts' decision to dramatically shrink the pharmacy network for the military health program TRICARE. → Read More
A new estimate finds that 18 million people could lose Medicaid coverage after the COVID-19 public health emergency ends, with 4 million becoming uninsured. | A new report estimates 18 million people could lose Medicaid coverage due to eligibility redeterminations, but most will be able to transition to other coverage sources. → Read More
Several patient and consumer advocacy groups are clamoring for the Federal Trade Commission (FTC) to examine the role of group purchasing organizations in exacerbating supply chain shortages. | A collection of patient and consumer groups is pressing the FTC to examine the role of group purchasing organizations in supply chain problems. → Read More
A new hospital industry report charges that safety net and charity care hospitals are losing millions due to drug companies cutting off sales of pharmaceuticals discounted under the 340B program to | A new AHA report charges that average charity care hospitals are losing an average of $3 million a year in 340B savings as drugmaker restrictions take hold. → Read More
As Congress returns this week from a nearly monthlong recess, a collection of hospital groups is making sure resolution of a looming 4% cut to Medicare payments doesn’t slip through the cracks. → Read More
The Supreme Court heard oral arguments Tuesday in a case that could decide whether Medicaid beneficiaries can sue the federal government if their rights are violated. | The Supreme Court heard oral arguments Tuesday on a case that could decide a Medicaid beneficiary's right to sue over nursing home treatment. → Read More
A new alliance hopes to persuade lawmakers to keep around a 5% bonus to doctors that sign up for payment models and raise awareness on the benefits of value-based care. | A new advocacy alliance is pushing Congress to keep a 5% bonus to doctors that sign up for alternative payment models, which is set to expire after this year. → Read More
A new report found nearly 10 states reported higher complaints of Medicare Advantage (MA) marketing, including complaints of seniors being misled about a plan’s benefits. | A new Senate report found that nine out of 10 states had higher complaints surrounding Medicare Advantage marketing practices from 2020 through 2021, with a key senator calling for CMS to crack down on such practices. → Read More
Doctor groups are making a last gasp to get Congress to delay a 4.4% cut to Medicare payments after a payment rule finalized the adjustment. | Doctors are now turning to Congress in a high-stakes bid to head off a 4.4% cut to Medicare payments set for 2023 after CMS finalized the cuts in a recent payment rule. → Read More
A key panel wants greater transparency from federal regulators and states to chart the unwinding of the COVID-19 public health emergency and with it a massive effort to redetermine Medicaid eligibi | MACPAC is calling on states and CMS to publicly release key progress reports on the unwinding of the COVID-19 emergency, which will spark a massive redetermination of Medicaid eligibility. → Read More
The Biden administration is increasing scrutiny of nursing homes that fail to meet quality standards or make improvements, the latest bid to overhaul how such facilities are evaluated. | CMS is cracking down on nursing homes that are habitual poor performers, adding stiffer penalties to a quality improvement program. → Read More
The Department of Health and Human Services (HHS) dinged drug giant Merck for cutting off 340B sales to hospitals’ contract pharmacies, potentially setting off a new legal battle over the controver | HRSA is calling for Merck to get fined for cutting off sales of 340B-discounted drugs to a safety net hospital's contract pharmacies. → Read More
Tenet lowered its financial outlook for its surgical center subsidiary United Surgical Partners International due to more spikes in COVID-19 cases. | Tenet lowered the 2022 financial outlook for its surgical center subsidiary United Surgical Partners International after Hurricane Ian forced the closure of 60 centers. → Read More
Nonprofit community Medicare Advantage (MA) insurers touted more five-star plans compared to their competitors, according to a new analysis. | Nonprofit community Medicare Advantage plans made up one-third of plans that garnered five stars, an analysis from the Alliance of Community Health Plans. → Read More
House lawmakers are pressing for federal regulators to extend telehealth flexibilities to prescribe medication-assisted treatments to combat opioid abuse amid concerns over the “unpredictable futur | House lawmakers want SAMSHA and DEA to make long-term flexibilities to physicians for prescribing the opioid abuse treatment buprenorphine. → Read More
Providers that participated in value-based care generally fared better financially during the worst parts of the COVID-19 pandemic when non-essential procedures were largely on pause. | CMMI Director Liz Fowler said that while the pandemic spurred greater interest in value-based care, lingering financial pressures are delaying such investments. → Read More
Patient volumes continue to remain below pre-pandemic levels for hospitals and health systems this year as COVID-19 likely accelerated a shift to outpatient settings, a new report finds. | Hospital patient volumes continue to track below pre-pandemic levels for 2022 likely due to a shift to outpatient settings, a new Kaufman Hall survey found. → Read More