Category: Modern Healthcare

A Senate health panel could spur federal action on out-of-network billing as lawmakers mull intervention in escalating health costs.

The retirement of the high court’s swing vote has spurred vocal outcry from abortion-rights groups as anti-abortion activists eye potentially overturning Roe v. Wade as the bench turns more conservative.

The CMS has turned down Massachusetts’ request to choose which drugs it will cover for Medicaid patients. Advocates had worried the request, an effort to keep costs down, would prevent access to innovative and life-saving drugs.

The U.S. Supreme Court on Wednesday dealt a blow to public unions’ ability to collect fees from non-members, ruling the practice violates those workers’ free speech rights.

Modern Healthcare’s Tara Bannow is attending the Healthcare Financial Management Association’s annual conference in Las Vegas. Here are some takeaways from presentations and meetings on Tuesday.

Sanford Health will merge with Good Samaritan Society, mirroring other health systems that have made a play for long-term care providers to try to better coordinate care once patients leave the hospital.

Mayo Clinic and Blue Cross and Blue Shield of Minnesota have agreed to a five-year contract that includes downside risk, more coordinated care for patients with complex and serious illnesses, and the elimination of some prior authorizations.

The CMS will take a closer look at Medicaid managed-care plans to ensure they are adhering to medical loss ratio standards. The agency will also increase audits of who states enroll in Medicaid.

About half of individuals considered to be at high risk for contracting HIV reported they were not offered testing by their physicians during a clinical visit, which experts say has hindered efforts to reduce the number of new infections.

The Senate Finance Committee’s first formal hearing on drug prices with HHS Secretary Alex Azar failed to firm up policy goals even as heightened congressional scrutiny puts drugmakers on edge.