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Industry News

Jan 23, 2019

President Donald Trump on Wednesday threw his support behind curbing balance billing practices, saying his administration has "stopped a lot" of industry pricing tactics already.

"We're going to stop all of it, and it's very important to me," Trump said as cameras rolled during the portion of a roundtable discussion on healthcare with his top deputies and patients from around the country with stories of unexpected high medical costs.

Senators from both parties are currently...

Jan 23, 2019

The number of U.S. adults who do not have health insurance was higher in the fourth quarter of 2018 than it has been since the Affordable Care Act was implemented four years before. Women, young adults, and lower-income people have experienced the greatest increases in uninsured rates in the last two years, according to the latest survey data from Gallup.

According to Gallup, which has tracked the uninsured rate each quarter since 2008, 13.7% of adults were uninsured during the...

Jan 23, 2019

The controversial 340B drug discount program could be looking at a serious trim in California, home to the biggest Medicaid population in the country.

Health clinics and hospitals are monitoring a potentially huge money shift away from hospitals in the program in the wake of Democratic Gov. Gavin Newsom's sweeping executive order on drug pricing. The new governor's plan still has plenty of details to be worked out, but currently it would consolidate all the state's drug purchasers...

Jan 23, 2019

National pharmacy giant Walgreens will pay $269.2 million to settle two separate allegations that the chain defrauded the federal government and 39 states in elaborate overbilling schemes.

Walgreens has admitted responsibility for the fraudulent billing of the federal government and states alleged by the Justice Department, the U.S. attorney for Southern New York announced late Tuesday.

The first $209 million settlement resolved allegations that Walgreens billed Medicare,...

Jan 23, 2019
Maine's Democratic governor has told federal regulators that the state won't move forward on her predecessor's plan to require certain Medicaid recipients to work or volunteer.

Gov. Janet Mills wrote Tuesday to the CMS that she's instead directing Maine's health and labor agencies to help prepare recipients of governmental assistance for work.

Mills said former Republican Gov. Paul LePage's plan would have left more Mainers uninsured. She said Maine's low unemployment rate and...

Jan 23, 2019

A big jump in prescription drug sales, particularly overseas, helped Johnson & Johnson swing to a large fourth-quarter profit after posting a huge loss a year earlier, when it took a $13.6 billion charge related to the late-2017 U.S. tax overhaul.

The world's biggest maker of healthcare products also benefited from an effective tax rate of 2.6% for the latest quarter, amounting to just $80 million. That was the main reason J&J topped Wall Street profit expectations, Credit...

Jan 22, 2019

Type 1 diabetes has become a more costly disease to manage, thanks in large part to insulin costs nearly doubling over five years.

All in all, Type 1 diabetes costs rose from $12,467 in 2012 to $18,494 in 2016, according to a report released Tuesday by the Health Care Cost Institute. The group found the increased cost of insulin accounted for 31% of per-person healthcare spending in 2016, as the average annual out-of-pocket spending for insulin jumped from $2,864 to $5,705 in that...

Jan 22, 2019

Thirty-eight hospitals sued HHS on Friday over a new rule that cuts Medicare payments for some services provided at off-campus hospital sites.

The lawsuit claims HHS Secretary Alex Azar acted beyond his statutory authority when he cut payment rates for evaluation and management services provided at the hospital sites so that they aligned with those paid to physicians' offices; the final rule took effect Jan. 1.

"The secretary's rule is irrational, a patent misconstruction of...

Jan 22, 2019

A small Ohio hospital is pushing the CMS to resurrect its ability to care for Medicare and Medicaid patients after the agency revoked its funding because the facility doesn't serve enough patients.

The Medical Center at Elizabeth Place, a 12-bed hospital in Dayton, asked the CMS to resume Medicare and Medicaid payments that were terminated on Jan. 18. Federal lawmakers from Ohio are also pushing the agency to resume payments and give the facility an extension to meet agency...

Jan 22, 2019

The partial government shutdown, now on its 32nd day, has dried up a key cash flow for at least one rural hospital: a $3.2 million low-interest rural development loan from the U.S. Department of Agriculture.

In the case of the small not-for-profit medical center in Pecos, N.M., the shutdown's freeze of USDA funding also halted financing of a costly construction project when the official in charge of the loan went on furlough. The project, a 9,000-square-foot expansion to bring all...

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