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Industry News

Jul 18, 2018

The CMS plans to open a new 30-day federal public comment period on Kentucky's Medicaid work requirement demonstration as a way to overcome a federal judge's objections to the way the waiver was approved.

A CMS spokesman said Wednesday that the new public comment period on the Kentucky demonstration, first reported by Politico, would "better inform any future decision on the demonstration that was remanded back to the department for further review."

Catherine Easley of the...

Jul 18, 2018

Community Health Systems announced Wednesday it plans to sell two of its Arkansas hospitals and their associated operations to not-for-profit Baptist Health in Little Rock.

The Franklin, Tenn.-based for-profit hospital chain has signed a definitive agreement to sell 492-bed Sparks Regional Medical Center in Fort Smith and 103-bed Sparks Medical Center in Van Buren, which together with their physician clinics and outpatient services comprise Sparks Health System. CHS said in a news...

Jul 18, 2018

The large price increases on brand name drugs and the high prices of new specialty drugs are driven by a desire for greater profits and not by the cost of research.

The pharmaceutical industry no longer makes significant investments in drug discovery. Its pipeline depends on discoveries made in academic medical centers with federal funding. Under the Bayh-Dole Act, enacted in 1980, manufacturers acquire the exclusive rights to those drugs and are free to sell them at any price. That...

Jul 18, 2018
HHS Secretary Alex Azar has chosen Adam Boehler to serve as the agency's senior advisor on value-based care efforts.

Boehler is now director of the Center for Medicare & Medicaid Innovation and will continue in that role.

"[Boehler] is the kind of results-oriented, transformational leader we need to deliver on what President Trump has promised the American people: better healthcare at a lower cost," Azar said in a statement.

Moving to value-based care is one of Azar's...

Jul 18, 2018

CMS officials on Wednesday assured clinicians that the agency's proposed changes to Medicare billing codes shouldn't significantly lower physician pay.

"It's a concern we are exquisitely mindful of," said Dr. Anand Shah, chief medical officer at CMS' Center for Medicare and Medicaid Innovation, said at a live-streamed event Wednesday. "That being said, our internal analysis shows an impact up or down of about 1% to 2%."

Providers worry that the proposed changes will underpay...

Jul 18, 2018

A workaround by states to counter Trump administration cuts to Affordable Care Act subsidies has largely succeeded in protecting consumers from higher costs, California and 17 other states said.

The assessment came late Monday in a court filing asking U.S. District Judge Vince Chhabria to put a lawsuit involving the cuts on hold.

The filing says states have mostly protected subsidized consumers by allowing insurers to raise premiums on some plans offered on health care...

Jul 18, 2018
Five years after Tenet Healthcare Corp. bought four Chicago-area hospitals, the for-profit chain has reached a deal to shed its three remaining hospitals in the market.

The Dallas-based hospital chain announced Wednesday it has signed a definitive agreement with national hospital operator Pipeline Health and Chicago-based healthcare investment firm TWG Partners to sell Louis A. Weiss Memorial Hospital, Westlake Hospital, West Suburban Medical Center and their affiliated operations,...

Jul 17, 2018

Noridian Healthcare Solutions has retained its contract to process Medicare claims and root out fraud on behalf of the CMS. The contract has one base year and six option years and is worth more than $313 million, according to an award notice.

The CMS chose Noridian to continue work as the Medicare administrative contractor for Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming, home to 3.1 million Medicare fee-for-service beneficiaries,...

Jul 17, 2018
A federal judge late Monday tossed a petition by Planned Parenthood affiliates and the American Civil Liberties Union to block HHS' new funding criteria for the Title X family planning program from taking effect this year.

The ruling from U.S. District Judge Trevor McFadden in Washington leaves current grantees in limbo as they wait for HHS' upcoming funding decisions. Those awards will be based on new criteria that include a focus on contraceptive alternatives such as natural family...

Jul 17, 2018

The Senate health panel on Tuesday grappled with how new policies could curb the ever-increasing costs of the U.S. health system. The lawmakers came away with several questions that likely will recur as the federal government pushes forward with the shift to value-based care.

From standardized "care products" to benchmark pricing, here are four issues lawmakers and witnesses raised as they try to rein in spending that is set to reach 20% of gross domestic product within the next...