Author's posts
Payer Roundup—CMS delays deadlines for new bundled payment model
The Centers for Medicare & Medicaid Services is pushing back the deadline to participate in the Trump administration’s new bundled payment program, and Vermont is planning to regulate the White House’s recently announced associated health plans.
340B overhaul at the top of Congress, Azar’s mind
Congress and the Trump administration are planning speeches and hearings involving the 340B program next week, and it looks like an overhaul of the drug discount program might be on the horizon.
Nebraska Medicaid expansion appears to be headed for November ballot
The future of Medicaid in Nebraska appears to be in voters’ hands, as advocates claim to have collected enough signatures to put Medicaid expansion on the November ballot.
Pain management needs to go beyond traditional treatment
While the government and insurers are taking steps to curb opioid prescriptions and enhance treatments, nonmedication pain management needs to be pumped up as well to stop the problem at its core, executives at Amercian Specialty Health told FierceHeal…
Over 1M already left ACA plans in 2018
About 1.1 million people have already dropped from their exchange plan in 2018. While that decline is lower than it was in 2017, signaling greater stabilization, policy changes are likely to disrupt the marketplace next year.
Payer Roundup—Centene completes purchase of Fidelis; Bevin cuts off Medicaid dental, vision benefits
Another high-profile insurance merger is complete, and Kentucky’s governor is already slashing the state’s Medicaid program following his courtroom loss over work requirements.
GAO: 340B hospitals, outside pharmacies need more oversight
The 340B drug discount program is under scrutiny yet again. This time the GAO is calling for additional oversight of the program and its contracted pharmacies with a report that shows nearly half of covered entities didn’t pass drug discounts to low-in…
CMS makes decisions on two states’ Medicaid modification requests
The Centers for Medicare & Medicaid Services announced decisions on two states’ requests to modify their Medicaid programs this week. Important legal distinctions between the requests may have caused one to be approved and the other denied.
Payer Roundup—BCBS Minnesota gets new CEO; Molina sells subsidiary to DXC Technology
Blue Cross Blue Shield of Minnesota has named a new president and CEO, and on Capitol Hill, Democrats continue to push back against the administration’s decision to support a lawsuit that would roll back the Affordable Care Act.
OIG, GAO say CMS isn’t doing enough to curb Medicaid fraud
A day after CMS announced a new initiative to curb Medicaid fraud, witnesses from OIG and GAO told lawmakers HHS hasn’t acted on longstanding recommendations. They also said supplemental payments and demonstration programs lack the appropriate oversight.
