A coalition of 131 healthcare organizations is backing the Clinical Trial Modernization Act, which aims to expand patient access to clinical trials through financial support and other measures.
Two U.S. representatives have introduced the Prompt and Fair Pay Act, a bipartisan bill that would require Medicare Advantage plans to reimburse providers at least the same rates as traditional Medicare, as well as pay claims more promptly. Providers and industry groups have welcomed the proposal, citing mounting financial strain and growing concerns over care delays and denials.
In this episode hear how improving benefit verification, prior authorizations, and patient affordability with smart integrations and real-time eligibility can streamline healthcare workflows.
A bill introduced by Rep. Earl L. "Buddy" Carter would ban PBMs’ use of spread pricing in Medicaid, among other reforms.
Senators John Kennedy (R-Louisiana) and Eric Schmitt (R-Missouri) introduced a bill last week that would require “able-bodied adults” without dependents to work or volunteer for at least 20 hours per week to receive Medicaid benefits.
Senators Elizabeth Warren and Josh Hawley and Representatives Diana Harshbarger and Jake Auchincloss introduced the Patients Before Monopolies Act on Wednesday. It aims to prohibit the parent company of a PBM or insurer from owning a pharmacy business.
Two senators recently introduced a bill that seeks to regulate private equity firms’ involvement in the healthcare industry. If passed, the act would establish a criminal penalty of up to six years in prison for private equity executives whose business decisions result in a patient’s death.
Explore the top mobile IV therapy companies boosting immune health on demand, with standout services, expert care and innovative delivery across the U.S.
The Lower Costs, More Transparency Act has passed in the House with bipartisan support. The action is being applauded from several advocacy organizations.
This week, senators introduced a bipartisan bill that would make it a federal crime to assault hospital workers. Even though nearly 40 states have passed laws to intensify penalties for violent acts committed against healthcare personnel, there is currently no federal law protecting hospital employees from assault or intimidation.
The Medicaid Staffing Flexibility and Protection Act was introduced by Representative Earl L. “Buddy” Carter (R-Georgia) and Representative Neal Dunn (R-Florida). It would allow state Medicaid agencies to hire outside contractors to help with Medicaid redeterminations, as many agencies don’t have the workforce to handle the return to the redetermination process.
The Senate Finance Committee voted 26-1 to advance the Modernizing and Ensuring PBM Accountability Act. The bill has several provisions, including delinking PBM income from prescription drug prices under Medicare Part D and banning spread pricing in Medicaid.
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The Senate Commerce Committee held a hearing Thursday, which discussed how the Pharmacy Benefit Manager Transparency Act would affect practices by pharmacy benefit managers, including clawbacks. Some questioned why PBMs are even necessary.
The bill, if enacted into law, will establish an electronic prior authorization process and require Medicare Advantage plans to report on their use of prior authorization and the rate of approvals or denials to CMS. It has 227 co-sponsors in the U.S. House, indicating strong support from both Republicans and Democrats.
As the use of technology proliferates during the Covid-19 pandemic, concerns rise about privacy and health data security. Congressional Democrats have proposed new legislation that would protect individuals' data rights amid the public health crisis.
Congress finally reached an agreement on a $900 billion stimulus package, which includes a ban on surprise medical billing. A previous, but very similar version of the bill, raised concerns among providers and payers.
A bill introduced to the U.S. House of Representatives on Thursday would permanently lift site restrictions for Medicare patients to access telehealth. During the pandemic, several restrictions on where telehealth visits could be conducted and what services were eligible were temporarily lifted.