Category: Modern Healthcare

Bayer to stop sales of birth control device tied to injuries

The maker of a permanent contraceptive implant subject to thousands of injury reports from women and repeated safety restrictions by regulators said Friday that it will stop selling the device in the U.S.

New Catholic directives could complicate mergers and partnerships

Catholic officials, ethicists and observers said the rules approved by U.S. bishops last month could toughen church scrutiny of merger or partnership agreements, notably the pending huge merger of Catholic Health Initiatives and Dignity Health.

Drug rebates’ legal protections are on the chopping block

HHS is taking steps to remove legal protections for drug rebates that favor pharmacy benefit managers. It’s unclear whether the changes will actually lead to lower drug prices, experts say.

Anthem overturned most ER claims it denied under controversial policy

Anthem’s policy led to a big spike in coverage denials among ED patients in three states last year, according to a senator’s report. But Anthem ended up reversing the majority of denied claims that patients appealed.

CMS may propose restarting $10B risk-adjustment payments

The CMS sent a rule to the White House for review that may resume risk-adjustment payments to insurers. Patient advocates have claimed the agency was trying to sabotage the insurance exchanges by eliminating billions in payments.

Maryland updates price transparency website with new data, petition

Consumers can now sign a petition that lobbies Maryland providers and insurers to reveal their costs via the state’s updated price transparency website.

California ACA rates to rise almost 9% next year

The 1.4 million Californians who buy coverage on the state’s individual insurance exchange will pay more in 2019 in part because the federal government zeroed out the federal penalty for not enrolling in coverage.

California ACA rates to rise almost 9% next year

The 1.4 million Californians who buy coverage on the state’s individual insurance exchange will pay more in 2019 in part because the federal government zeroed out the federal penalty for not enrolling in coverage.

UPMC to end in-network coverage for Highmark’s MA members by July 2019

The Pennsylvania Supreme Court reversed a lower court’s ruling that UPMC had to cover Highmak Medicare Advantage members in-network through 2019, marking the end of a long-standing feud between the state’s largest health system and insurer.

Hospitals are flirting with Medicare for All

House Democrats launched a Medicare for All caucus and its founder says some hospitals have been cautiously supportive behind closed doors.