Policy and Legislation
The state last week won federal approval to shift most of its Medicaid recipients into managed care organizations, which are paid a fixed monthly fee from the state for each person in the plan. It's a strategy employed by about three dozen states, many for decades, to provide more predictable spending.
For the first time, the Centers for Medicare and Medicaid Services and America's Health Insurance Plans have announced standard quality measures among payers, a move designed to reduce confusion and complexity for reporting providers.
The Greater New York Hospital Association is pitching a $2.5 billion plan they say will ensure the financially distressed safety net hospitals throughout the state survive by paying the larger healthcare providers to integrate them into their own systems.
Despite much hand-wringing over the size and quality of provider networks on the health insurance marketplaces, many top-notch hospitals are available in-network in marketplace plans this year, a new study found.
Though President Barack Obama's proposed 2017 budget died almost as fast as it arrived at Congress on Tuesday, the chief executive's final proposal included millions in healthcare spending to bolster quality programs, improve interoperability and fight rising pharmaceutical prices.
Experts say the California exchange uses more of its powers as an "active purchaser" than any other state. That means it can decide which insurers can join the exchange, what plans and benefits are available and at what price.
The Department of Health and Human Services is looking at ways to improve the quality of care at facilities operated by the Indian Health Service, focusing especially on the Great Plains area.
In December 2014, Medicare began a pilot program in three states, including Pennsylvania, to cut down on what officials believed were improper payments, including some possible fraud and abuse, in nonemergency ambulance services. The program moved to more aggressively enforce Medicare's long-standing policy requiring that beneficiaries be so weak they could only be moved on a stretcher before it would pay for repeated, nonemergency ambulance service.
In general, both praise and criticisms of the law are accurate. That's because the health law is so big and sweeping that it has had effects both positive and negative. Here is a brief guide to some things the health law has -- and has not -- accomplished since it was signed by President Barack Obama in 2010.
Former Turing CEO Martin Shkreli on Thursday invoked his Fifth Amendment rights while members of a Congressional committee grilled pharmaceutical executives about the high price of prescription drugs.