Dr. Oz describes a reimagined, technology-driven healthcare ecosystem
A rapid acceleration of digital healthcare applications and a sharpened focus on fraud, waste and abuse will be central to the looming transformation of the U.S. healthcare system, Mehmet Oz, MD, administrator of CMS, told a healthcare audience Wednesday. Oz spoke May 21 in Manhattan at the Not-for-Profit Healthcare Investor Conference, sponsored by HFMA, Barclays…
Court rules against drug companies on the question of a 340B rebate model
Hospitals hoping to avoid having to use a rebate model in the 340B Drug Pricing Program received good news in court recently. A federal judge issued a May 15 written opinion that the Health Resources and Services Administration (HRSA) was within its rights to deny four drug manufacturers unilateral authority to implement a rebate model…
Budget reconciliation bill faces a rocky road as Medicaid and ACA cuts draw provider concerns
In the days after a key House committee approved legislation that includes substantial cuts to Medicaid funding, the bill’s path forward remained full of obstacles. The healthcare portion of the budget reconciliation bill passed the Energy and Commerce Committee on a party-line 30-24 vote May 14. Since then, reports from Capitol Hill have detailed the…
RFK Jr. defends HHS budget to Congress and talks Medicaid, 340B and more
In congressional testimony, HHS Secretary Robert F. Kennedy Jr. endorsed proposed Medicaid cuts as affecting fraud, waste and abuse rather than beneficiaries who most need the program. Speaking May 14 before a House Appropriations subcommittee and later the Senate Health, Education, Labor and Pensions (HELP) Committee, Kennedy also indicated a willingness to pare down the…
Medicaid provider payments take a hit in budget reconciliation bill
As released over the weekend, formalized plans to reduce federal Medicaid spending would have an impact on future state-directed supplemental payments and other aspects of the program. The House Energy and Commerce (E&C) Committee published its portion of a budget reconciliation bill that would slash 10-year projected federal spending. As expected, Medicaid would incur the…
Providers, payers both struggle with Medicare Advantage challenges
Note: This article was updated May 13 where noted. Neither providers nor a leading payer are finding much reason for satisfaction with the state of Medicare Advantage (MA) these days. Q1 financial reporting by for-profit hospital chains and by UnitedHealth Group (UHG), among other payers, have reflected the challenging landscape. UHG in April shared what…
Hospitals grapple with uncertain tariff fallout as pharmaceutical levy looms
May 28 update: A U.S. trade court has issued an injunction on most of the tariffs imposed by the Trump administration, although tariffs on individual products (e.g., steel and aluminum) can remain. The administration has appealed the decision. May 29 update: The tariffs are back on for now after an appeals court stayed the lower…
CFPB no longer supports the final rule on medical debt reporting
The Consumer Financial Protection Bureau (CFPB) has formally withdrawn its support for a Biden administration rule that would keep medical debt from appearing on consumer credit reports. The rule has been staunchly opposed by the credit-reporting and debt collector industries and also has generated concern among provider advocates who think it could remove an incentive…
Trump proposes big spending cuts to healthcare programs
President Donald Trump’s FY26 budget proposal includes significant cuts to healthcare programs, but the administration says the reductions will not affect core services. The budget is merely a set of recommendations, given that federal budgetary authority resides with Congress. Trump’s proposals are likely to hold influence with the narrow Republican majorities in both chambers, but…
Blue Cross Blue Shield settlement concerns linger as date of final approval nears
Nearly 15,500 healthcare providers are known to have withdrawn from the record-setting Blue Cross Blue Shield antitrust settlement, retaining the option to pursue separate litigation. The number was listed in an April court filing as the parties move toward a July 29 hearing at which the presiding court is scheduled to consider final approval of…