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Medicare Drug Price Negotiation; Diagnostic Errors

Also in TTHealthWatch: neomycin for preventing respiratory viral infections

A photo of a Humana health insurance building.

Discerning the Truth About the Medicare Advantage Controversy

Evidence shows higher-quality care compared with fee-for-service, but also overpayments

A photo of a nurses hand on the shoulder of a senior man sitting in a wheelchair.

CMS Pushes Back on Criticism of Nursing Home Staffing Rule

Rule is needed because many nursing home patients don't get needed care, CMS administrator says

A screenshot of HHS Secretary Xavier Becerra speaking during this hearing.

Becerra Gets Sharp Questions From All Sides at Budget Hearing

House members cite lack of action and funding on physician payment reform and other issues

A screenshot of Frank Pallone speaking during this hearing.

Improper Payments in Medicare and Medicaid: Who's at Fault?

Republicans and Democrats took differing approaches on the subject at a House hearing

A photo of a male hospital pharmacist filling a medication order.

The 340B Program Isn't Going Anywhere, Lawmaker Tells Hospital Executives

Rep says it's a great program that helps rural areas, and needs to continue

A photo of cash sticking out of several prescription medication bottles.

MedPAC Wrestles With Wide Variation in Generic Rx Prices, Availability

Commissioners baffled by factors affecting Part D drug prices

A photo of a senior woman holding on to railings during a physical therapy session.

Congress Can Take Action to Prevent Older Adult Falls and Associated Opioid Use

The bipartisan SAFE Act offers important solutions

A close up photo of a urinary catheter

CMS Officials Pressed on Catheter Fraud Issue at Accountable Care Meeting

"We just kindly ask that you address the issue with higher urgency," said one ACO member

A screenshot of Amol Navathe, MD, PhD, speaking during this hearing.

More Medicare $$ Needed to Pay Docs for Treating the Chronically Ill, Senators Told

Payment codes are underused because "the cost of billing them is itself unprofitable"

A screenshot of Lee Schwamm, MD, speaking during this hearing.

House Members Struggle to Craft Road Map for Future of Telehealth

Lawmakers examine issues around reimbursement, licensure, and patient choice

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More Health Systems Likely to Drop Out of Medicare Advantage, Analyst Predicts

Claims denials, prior authorizations are just some of the reasons, he says

A close up photo of two Wegovy injection pens.

Medicare Can Cover Anti-Obesity Drugs for Heart Disease -- But at What Cost?

Intense demand coupled with high costs may place pressures on CMS for years to come

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Here's What Medicaid Expansion Can Do for the Health of Your State

Texas -- and 10 other states -- should accept this additional federal funding

A photo of President Joe Biden and Vice President Kamala Harris during the State of the Union speech.

Victory Over Big Pharma Will Take More Than the IRA

We need policies to address high launch prices and anti-competitive patent practices

A photo of a female physician in her office, typing on a laptop

Washington and New Jersey Are Reforming Prior Authorization. Is Your State Next?

Broad grassroots support can make a big difference

A photo of a male physician taking notes while meeting with his mature female patient

Medicare Debuts Another Primary Care-Focused Accountable Care Model

Primary Care Flex will pay ACOs a monthly fee to be given to primary care practices

A photo of a box of Wegovy injection pens.

Medicare to Cover Weight-Loss Drug Wegovy for Certain Patients

News comes in the wake of FDA approval to reduce risk of heart attacks, stroke

A photo of seniors in a nursing home.

The Case for Stricter Standards in the Final Nursing Home Staffing Rule

Continued understaffing will have devastating consequences for residents, families, and staff

A photo of three capsules lying on the Pharmaceuticals & Biotech stock listings in Financial Times newspaper.

What's Happening With the Medicare Drug-Price Negotiation Lawsuits?

The government has come out on top so far, but pharma vows to fight on, expert says

A screen shot of Robert Morris speaking during this hearing

Medicare $$ Needed to Help State-Licensed Emergency Centers Survive, Lawmakers Told

"This model doesn't work" without it, says emergency center CEO

A photo of a senior patient using a walker in the hallway of a nursing home.

MedPAC's Report Recommends Pay Changes for Healthcare Services

Report highlights MA quality, overpayment issues, and urges action on four prior recommendations

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MedPod Today: AAMC Leaked Emails; 'Wild West' of Ketamine; MA Games the System

口袋女优 reporters offer further insights on these recently covered topics

Morning Break over illustration of a syringe, Covid virus, and DNA helix over a photo of green vegetation.

Trump Reverses on Medicare Cuts; Pill for Ebola? Chef Jailed for Serving Norovirus

Health news and commentary from around the Web gathered by 口袋女优 staff

A screenshot of Xavier Becerra speaking during this hearing.

Republican Senators Blast Biden's Proposed HHS Budget

At issue were the exclusion of PBM reform, and nursing home, Title X funding requirements

A close up photo of a man wearing scrubs and holding a tiny graduation cap.

It's Match Week, but That Won't Fix the Physician Shortage

Short-term legislative solutions can help today in the face of stagnant systemic change

A photo of the Hubert H. Humphrey building in Washington, D.C.

HHS Aims to Lower Drug Costs, Fund Public Health Preparedness in Budget Proposal

Another goal of FY 2025 budget is to protect reproductive healthcare, behavioral health workforce

A photo of a table set up in front of a van advertising Medicare Advantage plans to passersby.

MedPAC Wrestles With How to Fix Deep Flaws in Medicare Advantage Quality Metrics

Comparing MA plans with fee-for-service quality called "a hornet's nest"

A photo of the interior of an Aledade office.

Largest Independent Primary Care Network in the U.S. Accused of Medicare Fraud

Whistleblower lawsuit alleges Aledade encouraged doctors to tack on suspect medical diagnoses

A photo of ambulances outside of a hospital in Montgomery, Alabama.

MedPAC Members Pan Rural Hospitals' 'Cost-Plus' Billing System for Medicare Patients

Allowing the system to stay in place is "unconscionable," says one commissioner

A photo of Christopher Koller speaking during this hearing

Medicare a Big Contributor to the Broken Health Payment System, Senators Told

Use of "hybrid" payment model urged

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Most Doc Groups Unhappy With Proposed Congressional Budget Deal

Measure would restore some, but not all, of the cuts to the Medicare Physician Fee Schedule

A scanning electron microscope image of a respiratory syncytial virus

Congress Should Simplify Medicare's Vaccine Coverage

All ACIP-approved vaccines should be covered by Medicare Part B

A photo of Donald Berwick, MD

Obama CMS Chief: Medicare Advantage Plans Game the System

Don Berwick says MA growth "should be slowed or stopped"

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FDA Authorized Florida's Drug Importation Plan. Naysayers Are Balking.

It's not an efficient solution

A photo of a billboard which reads: Medicare plans with dental + eyewear.

How Beneficiaries Really Feel About Medicare Advantage vs Traditional Medicare

MA plans offer "extra benefits" but many go unused. Is Medicare Advantage really better?

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There's Still Time to Switch Medicare Advantage Plans This Year

Beneficiaries have until March 31 to find a new plan; doctors should check plans, too

A photo of Jesse Ehrenfeld, MD, MPH

'Humbling, Exhausting, Exhilarating': The Life of AMA President Jesse Ehrenfeld

Some of the most meaningful experiences happen in unexpected places, he says

AAOS over a photo of Moscone Center in San Francisco, CA

Orthopedic Surgeons on Track to Earn Less Than Taco Bell Workers

If current trends continue, patients are in big trouble

A photo of Rep. Larry Bucshon (R-Ind.) speaking at this event

Not Passing a Bill to Fix Medicare Doc Pay Cuts Is 'Appalling,' Lawmaker Says

Rep. Larry Bucshon, MD, also talks about prior authorization, violence against health workers

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