As one of the last acts of President Joe Biden's term, the administration listed the prescription pharmaceuticals that would be included in the second round of the program that allows the Centers for Medicare and Medicaid Services (CMS) to negotiate what it pays for certain drugs.
The announcement was made earlier than the...
A lobby group representing large employers has sued to halt the implementation of a rule issued under President Joe Biden that would enforce a 2008 law requiring mental health parity by health insurance plans. Millions of Americans are affected by mental illness each year.
The ERISA Industry Committee (ERIC) has filed a lawsuit on...CMS Rules
The proposals were rolled out early in preparation for the incoming Trump administration, and it remains unclear what changes the incoming office will make to the proposed rule.
According to STAT, the Centers for Medicare and Medicaid Services (CMS) proposed to increase benchmark payments for MA plans by 2.2% for 2026, as opposed to...National News
The Centers for Disease Control and Prevention (CDC) published its early release of quarterly estimates from the National Health Interview Survey which found relatively low uninsured rates across the country from 2023 to June 2024.
The report included select estimates of healthcare statistics for the non-institutionalized U.S....CMS Rules
On Monday, the Biden administration announced a new proposed rule by the U.S. Department of Health and Human Services (HHS) together with the Labor Department (DOL) and the U.S. Department of Treasury, that would expand access to contraceptive products by making them free to all women of reproductive age with private health...CMS Rules
On Tuesday, the Biden administration released guidance on rules for the Medicare Prescription Payment Plan, a key aspect of the healthcare initiatives laid out in the Inflation Reduction Act of 2022 that aims to lower out-of-pocket costs for seniors with Medicare Part D prescription drug coverage.
The program is slated to launch in...Arizona News
This week in Medicaid a judge sides with the Centers for Medicare and Medicaid Services (CMS) against work requirements, the North Carolina Medicaid expansion remains on pace for over 600,000 additional members and the status of 1115 Waiver renewals nationwide.
The Georgia Pathways to Coverage program was the only one in the nation...National News
The U.S. Supreme Court has agreed to take up an appeal from the Biden administration in cases against states that have implemented laws that prohibit gender-affirming care for transgender people and minors.
The case involves laws in Tennessee and Kentucky that restrict puberty blockers and hormone therapy for transgender people under...
Patients, physicians, home health aides, advocacy groups, stakeholders and more all happily replied to a request for information (RFI) collecting feedback for the Centers for Medicare and Medicaid Services (CMS) on Medicare Advantage data policies and procedures. Turns out, MA isn't very popular among many stakeholders.
The RFI came...
Nursing home advocacy groups have filed a lawsuit against the Biden administration's federal staffing minimum rule, which was promised in the wake of the devastation in nursing homes and exacerbation of nursing staff shortages caused by the COVID-19 pandemic.
It should come as no surprise that the American Health Care Association...CMS Rules
The Biden administration's nursing home minimum staffing rule could have a major impact on states' Medicaid programs, adding another layer of complexity to the highly anticipated and very controversial rule.
The nursing home minimum staffing rule is estimated to cost the residential care home industry up to $6.5 billion in additional...
The Biden administration finalized federal staffing requirements for nursing homes on Monday. The rule requires a registered nurse be on site 24 hours a day and enough staff to provide each patient with 3.48 hours of care per day which is higher than was originally proposed.
For facilities with 100 residents, this equates to a minimum...
Late last year the Cigna-Humana merger fell through after the two sides couldn't agree on a price and a hostile antitrust regulatory environment and industry opposition to consolidation ended the deal, but with Humana stock down 32% and Cigna's up 36% the math now works for a possible deal.
In December 2023 the two companies announced...Available To All
This week the U.S. Supreme Court heard oral arguments for a case that could not only overturn the U.S. Food and Drug Administration's authorization of the abortion pill mifepristone but also open the door for the courts to question decisions made by government agencies.
Even the justices appointed by former President Donald Trump...National News
Fewer Americans are uninsured than ever before according to new data from the Centers for Disease Control and Prevention (CDC). These numbers are anticipated to rise as Medicaid redeterminations continue.
The U.S. Department of Health and Human services (HHS) announced the milestone on August 3, boasting a 7.7% uninsured rate for the...National News
President Joe Biden has issued a proposal to restrict the sale of short-term health plans that don't meet requirements stipulated by the Affordable Care Act. The proposal would reverse a Trump-era rule that expanded the sale of short-term, limited duration health insurance (STLDI) plans and critics of the president are accusing the...CMS Rules
The Biden administration issued a proposed rule through the Centers for Medicare and Medicaid Services that aims to increase transparency of prescription drug costs and managed care plan operations for Medicaid enrollees.
It would do this by implementing a new drug price verification survey tool and requiring the inclusion of drug...
Today is the last day of the COVID-19 public health emergency (PHE), and policies are rapidly shifting to accommodate the post-pandemic healthcare landscape in the U.S.
On Tuesday, the Drug Enforcement Administration (DEA) announced that it would continue allowances for telehealth companies to prescribe controlled substances for six...
The U.S. Supreme Court heard arguments last week on an issue regarding retail pharmacies overcharging government health plans that could compromise the False Claims Act.
The case dates from 2006, when Walmart offered unsustainably low drug prices to cash customers and charged Medicare and Medicaid plans far higher than the original...
Late last Friday, Judge Matthew Kacsmaryk of the U.S. District Court for the Northern District of Texas issued a ruling that invalidated the U.S. Food and Drug Administration's authorization of mifepristone, one of two drugs used in combination to induce abortion. The Washington Attorney General Bob Ferguson then attempted to intervene...
