Category: Regulatory

March 31, 2023

Victoria Ferrell Ortiz learned she was pregnant during summer 2017. The Dallas resident was finishing up an AmeriCorps job with a local nonprofit, which offered her a small stipend to live on but no health coverage. She applied for Medicaid […]

March 30, 2023

The COVID-19 pandemic highlighted the struggles of front-line healthcare workers including long-standing issues like staffing shortages and burnout. Some workers have taken action through union organizing, picketing and strikes to secure new contracts with terms to quell challenges — especially […]

March 30, 2023

A federal judge on Thursday overturned a portion of the Affordable Care Act that makes preventive services, such as some cancer screenings, free to enrollees, a decision that could affect health insurance policyholders nationwide. The decision from the U.S. District […]

March 23, 2023

Medicare Advantage, the private-sector alternative to original Medicare, now enrolls nearly half of all Medicare beneficiaries. But it remains controversial because — while most of its subscribers like the extra benefits many plans provide — the program frequently costs the […]

March 20, 2023

During a four-hour hearing last week that could eliminate nationwide access to a common and widely used abortion pill, federal Judge Matthew Kacsmaryk, of the Northern District of Texas, signaled his conservative Christian beliefs early and often. Speaking from the […]

March 16, 2023

While Congress laid out the broad principles for Medicare to negotiate “maximum fair” prices for drugs, much of the process and details were left to the CMS to develop this year ahead of negotiations starting in 2024 for a first […]

March 7, 2023

President Joe Biden on Tuesday unveiled his plan to keep Medicare solvent for at least 25 years without cutting benefits, as the insurance program faces a looming funding crisis. The plan — part of Biden’s 2024 budget proposal set to […]

February 28, 2023

Hospitals realized stronger financial performance in January 2023 compared to the previous year, as the start of 2022 coincided with the Omicron variant surge. The median year-to-date (YTD) operating margin index for hospitals was -1% in January 2023, compared to […]

February 27, 2023

The federal government’s ban on surprise bills took effect at the start of 2022 in effort to protect patients from being stuck with hefty medical bills when providers and payers fail to agree to pricing terms. To remove patients from […]

February 24, 2023

Federal judges in Texas have delivered time and again for abortion opponents. They upheld a state law that allows for $10,000 bounties to be placed on anyone who helps a woman get an abortion; ruled that someone opposed to abortion […]

February 23, 2023

Washington has joined more than a dozen other states in seeking to crack down on toxic substances in cosmetics after a state-funded study there found lead, arsenic, and formaldehyde in makeup, lotion, and hair-straightening products made by CoverGirl and other […]

February 20, 2023

While the current state of patient matching is best described as tumultuous, progress toward a solution is being made thanks to efforts of stakeholders from across the spectrum. In the past year alone, we saw Section 510 temporarily removed from […]

February 20, 2023

In the US alone, an estimated 1.9 million new cases of cancer were diagnosed in 2022, positioning oncology as a key subject of clinical research. Throughout oncology trial development, it is important that stakeholders acknowledge that only patients can fully […]

February 10, 2023

A number of pandemic-era policies tied to the federal public health emergency will soon expire on May 11, affecting providers, payers and others in the industry that have relied on some of those flexibilities over the past few years. Waivers […]

February 10, 2023

Drugmakers will be required to pay rebates to the federal government for price increases in Medicare that exceed the rate of inflation beginning in 2025, the CMS said Thursday. The timeline is part of initial guidance the agency released for […]

February 8, 2023

President Joe Biden targeted high prescription drug costs Tuesday night in his State of the Union address, in addition to touching on other healthcare issues including the opioid crisis, abortion, Medicare solvency, surprise billing and more. He called for extending […]

February 8, 2023

President Joe Biden on Tuesday delivered his State of the Union address to a politically divided Congress for the first time, calling for permanent fixes on policy priorities like unaffordable health costs. In one marked difference from his earlier speeches, […]

February 7, 2023

A judge in Texas again ruled against the federal government over its implementation of the ban on surprise medical bills and said the third party process to resolve payment disputes is unlawful and unfairly favors insurers. Judge Jeremy Kernodle of […]

February 1, 2023

This is the latest legal challenge from the Texas Medical Association in its extended fight against arbritration provisions stipulated in the No Surprise Act. The federal law, which went into effect in January 2022, aims to protect consumers from pricey […]

January 31, 2023

Providers and drug manufacturers have been at odds for years over the 340B drug discount program, which requires pharmaceutical companies to give discounts on outpatient drugs for providers serving low-income communities. Such providers usually have narrower margins, meaning the drug […]