Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Federal Regulation

ACA “Skinny Repeal” Dies in Senate, Leaving Next Steps Uncertain

by Jennifer Bresnick

In the early hours of Friday morning, the Senate failed to pass its attempt at a “skinny repeal” of the Affordable Care Act, which would have eliminated the tax penalties associated with the individual mandate for insurance...

Senate Nixes Better Care Reconciliation Act, But Isn’t Done Yet

by Jennifer Bresnick

After a nail-biting procedural vote on Tuesday afternoon that required Vice President Mike Pence to break the tie, the Senate continued its tumultuous afternoon by voting down the Better Care Reconciliation Act, which included deep cuts to...

Tiebreaker Vote in Senate Opens ACA Repeal, Replacement Debate

by Thomas Beaton

In a 50-50 procedural vote, Vice President Mike Pence broke the tie as the US Senate voted to open debate for a future vote on American Health Care Act (AHCA), and the possible addition of amendments to the bill. After failing to...

CMS: Reinsurance, Risk Adjustment Programs Worked Well in 2016

by Jesse Migneault

CMS has released the results from 2016 for reinsurance and risk adjustment transfers, two of the “three R’s” used to stabilize premiums in the Affordable Care Act (ACA) marketplaces.   This marks the third year the...

CBO Score Finds 22 Million People Will Lose Health Coverage

by Thomas Beaton

UPDATE: GOP Senators delayed the vote on the BCRA until after the July 4th congressional recess.  The Congressional Budget Office (CBO) released their revised cost estimate on the new ACA repeal bill, the Better Care and...

Senate Has Released Bill to Revise ACA Repeal Legislation

by Jesse Migneault

The Senate has released the working draft of the Better Care Reconciliation Act of 2017, revising the recently House-passed AHCA.   Both bills aim to repeal and replace the Affordable Care Act (ACA), which was passed in...

3 Whistleblower Suits Net over $60 Million in Medicare Fraud

by Jesse Migneault

Whistleblower lawsuits alleging Medicare fraud have been settled against two diagnostic testing companies, and a California doctor who was alleged to have falsely diagnosed cancer as a means to bill Medicare for expensive...

650 Medical Groups Sign On to Abolish Medicare Budget Panel

by Jesse Migneault

Over 650 medical organizations have signed a letter to Congress from the Healthcare Leadership Council (HLC) supporting the elimination of the Independent Payment Advisory Board (IPAB).  The HLC joins a chorus of support for two...

Medicaid Waiver Adds More Beds For Drug Addiction Treatment

by Jesse Migneault

To circumvent an obscure Medicaid requirement, seven more states applied to join California, Maryland, Massachusetts and New York to receive a Medicaid waiver to expand drug addiction treatment.   Current federal policy prohibits...

House Passes AHCA To Repeal and Replace ACA By 1 Vote Margin

by Jesse Migneault

The House has successfully passed the American Health Care Act (AHCA) to repeal-and-replace the ACA.  This was the House GOP’s second attempt to pass the bill, after the first vote was abruptly cancelled by Speaker Paul...

Healthcare Payers Seek Passage of Bill to Lower Drug Costs

by Jesse Migneault

The recently introduced the Fair Access for Safe and Timely (FAST) Generics Act seeks to reduce the timeline of bringing generic prescriptions to market and enjoys the support of healthcare payers. The philosophy behind the bipartisan...

Anthem Appeals Cigna Merger with Cost, Quality Arguments

by Thomas Beaton

Anthem has opened an appeal in the U.S District Court citing opportunities for increased consumer savings and quality of care weeks after the DOJ blocked its planned merger with Cigna. Anthem argued that the DoJ’s ruling neglected a...

Market Monopoly Cause of Court Blocking Cigna-Anthem Merger

by Thomas Beaton

The full opinion of United States District Court for the District of Columbia blocking Anthem’s acquisition of Cigna became publicly available earlier this week and provides details into the court’s decision. In the memorandum...

After Terminated Merger, Cigna Demands $13B from Anthem

by Thomas Beaton

UPDATE: Anthem has secured a restraining order against Cigna preventing the final dissolusion of the merger.  The temporary order will be reviewed during a Delaware Chancery Court hearing on April 10. After a court ruling ended...

Aetna, Humana Terminate Merger Deal After Court Defeat

by Thomas Beaton

Aetna and Humana have scrapped their merger plans after the Department of Justice blocked the deal due to antitrust concerns.  Aetna will pay Humana a $1 billion termination fee, included as part of the original agreement. The DOJ...

DC Tops Medicare List for Wasteful Healthcare Spending

by Vera Gruessner

When it comes to medical care reimbursement, one of the most pivotal issues is eliminating wasteful healthcare spending. The Council for Medicare Integrity released a report detailing wasteful healthcare spending throughout the Medicare...

Past Successes, Future Challenges of the Affordable Care Act

by Vera Gruessner

The Patient Protection and Affordable Care Act was first passed into law in 2010. Over the last five years, there has been ongoing debate and political action taken to combat the Act and essentially destroy the legislation. The Supreme...

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