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Industry News

Sep 20, 2018

Medicaid spending hit $592.2 billion in 2017, with federal expenditures accounting for $370.6 billion, or 63% of that sum, according to a new federal report issued Thursday.

That's up from $580.9 billion in 2016 when federal Medicaid spending was $368.2 billion.

The majority of spending was spent on traditional Medicaid enrollees such as children, disabled and frail individuals. The adult expansion population cost the federal government and states a total of $70.8 billion in...

Sep 20, 2018

Big Pharma is making a major push to reclaim $4 billion in Medicare Part D funds that Congress took away in the 2018 budget deal.

The move complicated negotiations on the opioids package that congressional leaders hope to finish by Friday but late Thursday Democratic leaders were staunchly opposed to making making a policy change.

The Pharma request would cost at least twice as much as opioids package itself, Democratic aides said. Meanwhile, Medicare Part D plans started...

Sep 20, 2018

Simplifying value-based care models and lowering spending on care delivery are key focuses for the Trump administration as it looks to shore up the Medicare trust fund, according to a senior White House official.

Earlier this year, the Trump administration revealed that the Medicare trust fund will be insolvent by 2026, three years earlier than last year's estimate.

Sep 20, 2018

Stunted operating margins persist for U.S. not-for-profit hospitals but improved cash on hand and cash-to-debt ratios bode well for the sector, according to a new report.

The Fitch Ratings report represented a mixed bag for not-for-profit providers.

Operating margins continued to deteriorate last year as salaries, wages and pharmaceutical costs increased. More Medicare and Medicaid beneficiaries came into the payer mix, and providers invested in new technology and resources...

Sep 20, 2018

A property tax exemption benefiting the state's not-for-profit hospitals was affirmed today by the Illinois Supreme Court.

In a unanimous opinion, justices upheld a 2016 appellate court ruling on the constitutionality of a six-year-old state law that allows not-for-profit hospitals to offset expenditures deemed charitable against their property tax liability.

Each of the state's 157 not-for-profit hospitals has taken full advantage of the exemption, according to the Illinois...

Sep 20, 2018

A Medicare model meant aimed at patients who wanted hospice as well as curative care did not do well in its first year because hospice providers fled the program and doctors were disinterested in participating in it, according to a new federal evaluation.

The CMS five-year experiment, known as the Medicare Care Choices Model launched in January 2016. The model was created because...

Sep 20, 2018

Twenty-nine Next Generation Accountable Care Organizations have formed a coalition to advocate for CMS policies that will help the ACOs maintain long-term viability.

The Next Gen ACO Coalition, announced Thursday, will push for changes to the CMS' Next Generation ACO Model to make it more predictable and transparent.


Sep 20, 2018

In the middle of a hotly contested governor's race in Michigan, TV ads remind voters that more than 680,000 of them “can now afford to see a doctor when they need one.”

Five years ago, state lawmakers approved a plan to let adults with incomes up to 133% of the federal poverty level sign up for Medicaid. As it turns out, the move allowed recipients to afford many other things.

In new research that's fallen under the radar despite healthcare being a flashpoint in the upcoming...

Sep 20, 2018
Three major Boston hospitals paid HHS nearly $1 million for violating patients' HIPAA rights during the filming of a TV documentary series.

HHS on Thursday announced three separate settlements with Boston Medical Center, Brigham and Women's Hospital and Massachusetts General Hospital "for compromising the privacy of patients' protected health information" as film crews shot ABC's "Save My Life: Boston Trauma" documentary series.

In 2016, New York-Presbyterian Hospital had to pay a...

Sep 20, 2018

At his surgery center near San Diego, Rodney Davis wore scrubs, was referred to as "Dr. Rod" and carried the title of director of surgery. But he was a physician assistant, not a doctor, who anesthetized patients and performed liposuction with little input from his supervising doctor, court records show.

So it was perhaps no surprise, in 2016, when an administrative judge stripped Davis of his license, concluding it was the only way to "protect the public." State officials also...