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Colorado to vote on single-payer healthcare in 2016


Coloradans this fall will vote on a single-payer plan in which they would still pick their own providers, but the new system would pick up all the bills. There would be no deductibles, and fewer and smaller copays.

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CMS releases Medicare payment data on home health providers


The data released Friday in the "Home Health Agency Utilization and Payment Public Use File" contains information on utilization, payments, and submitted charges organized by provider, state and home health resource group. Read more »

House approves $1.1 trillion budget extending 'Cadillac' tax on high cost health plans for 2 years


The House on Friday approved a $1.1 trillion spending bill that, with a tax package approved last week, includes changes to ObamaCare including another delay in the implementation of the Cadillac tax on high cost employer health plans.

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Insurers find it too difficult to gain market share in mandated multi-state plans


A health law insurance program that was expected to boost consumer choice and competition on the marketplaces has slipped off course and is so far failing to meet expectations.

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Coalition calls for federal investigation of Medi-Cal reimbursement for alleged discrimination


A coalition of civil rights advocates Tuesday called for a federal investigation of California's Medicaid program, alleging that it discriminates against millions of low-income Latinos by denying them equal access to healthcare. Read more »

Congress to consider meaningful use payment incentives for docs in ambulatory surgical centers


Congress on Wednesday is considering legislation to allow physicians working in ambulatory surgical centers to receive the same payment incentives for meaningful use of electronic health records as doctors in other settings. Read more »

Physician groups want unique codes for billing and payment of biosimilar drugs


Under current law, reimbursement for biosimilars is calculated by a single code. Six physician groups that represent a wide swath of biologic-prescribing physicians, want to change that by urging Congress to press the Centers for Medicare and Medicaid Services to make unique codes for biosimilar medicines for billing and payment purposes.

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California targets uninsured 'hot spots' prior to open enrollment deadline


As the December 15 deadline for January healthcare coverage neared, California's insurance exchange intensified efforts to sign people up in pockets of the state with exceptionally high numbers of uninsured residents. Covered California targeted such "hot spots" as San Francisco's Mission district, and Oakland's Fruitvale neighborhood, officials said. Read more »

Intermountain VP says insurers need to shoulder some of the responsibility for price transparency


As patients face high deductibles, price is a major topic that's put pressure on healthcare providers to offer price transparency, even though what a hospital charges can be far different from what a patient actually owes after their insurance covers some of the costs. Read more »

Uninsured penalty for those eligible for Obamacare rises by $300 in 2016


Among uninsured individuals who are not exempt from the Affordable Care Act penalty, the average household fine for not having insurance in 2015 will be $661, rising to $969 per household in 2016, according to a Kaiser Family Foundation analysis. Read more »

State insurance exchanges healthy without federal funding, official tells Congress


State insurance exchanges are healthy financially even without the federal funding that ran out this year, a top Obama administration official told a House subcommittee Tuesday. But that official refused to predict if any of the remaining 13 state exchanges would eventually need to shift to the federal exchange. Read more »

Open enrollment numbers greater this year than last, CMS says


In total, 2.84 million consumers have made plan selections since open enrollment began Nov. 1, according to CMS. Read more »

Puerto Rico-based insurance holding company pays $3.5 million over HIPAA violations


Triple-S Management Corporation has agreed to settle potential HIPAA violations with the U.S. Department of Health and Human services to the tune of $3.5 million, after repeatedly failing to put safeguards in place for its beneficiaries' PHI. Read more »

Consumerism forcing providers to take on more risk and compete with insurers


The boundary between being a provider and a payer is blurring as hospitals face more risk, according to Joe Nichols of Health Data Consulting, prompting health systems to make changes to keep from losing too much money. Read more »

Obamacare repeal in budget heads to House


The U.S. Senate on Thursday approved a bill repealing the bulk of the Affordable Care Act in a vote of 52 to 47 that largely went along party lines. Read more »

CMS updates quality strategy in payment reform initiatives


CMS said by the end of next year, 85 percent of all traditional Medicare payments to quality or value and 30 percent of traditional Medicare payments should be tied to alternative payment models. Read more »

Liberty Mutual defends stance against data collection in Supreme Court


The case hinges on Vermont legislation requiring all administrators of self-insured benefit plans to regularly submit data on medical claims, pharmacy claims, member eligibility, provider and other information for use in the state's unified healthcare database. Read more »

Kentucky governor's plan to abolish state marketplace will not hurt consumers, expert says


Though the outgoing governor of Kentucky and other supporters of the president's Affordable Care Act have been critical of a pledge made by incoming governor Matt Bevin to abolish the state exchange in favor of switching to the federal marketplace, his plan may have little effect on consumers. Read more »

Close to 400,000 sign-up in week four as open enrollment deadline nears


With just two weeks left in 2015's open enrollment period, close to 395,000 consumers either signed up for or renewed health insurance coverage during week four November 22-28, according to the Centers for Medicare and Medicaid Services. Read more »

PPO plans to drop out-of-network cost limits


Forty-five percent of the silver-level PPO plans coming to the market for the first time in 2016 provide no annual cap for policyholders' out-of-network costs, an analysis by the Robert Wood Johnson Foundation finds. Read more »

No bail-out for insurance companies, group urges


The letter is an effort to continue limiting the amount of assistance insurers can obtain from the government to lessen losses they sustain under the Affordable Care Act. Read more »

Medicaid expansion results in more low-income women getting mammograms, study says


Women in Medicaid expansion states are far more likely to get screened for breast cancer, according to a new study by the Radiological Society of North America, which released the results at its annual meeting on Monday. Read more »

CMS credits new payment models in averting $19.8 billion in costs


From 2010 to 2014, there's been 2.1 million fewer hospital-acquired conditions; 87,000 fewer hospital-acquired condition related deaths; and $19.8 billion in costs have been averted, according to CMS Deputy Director Patrick Conway. Read more »

Average silver plan premiums for HMOs and PPOs rise significantly


While the average premium for the least expensive closed network silver plan -- principally HMOs -- rose from $274 to $299, a 9 percent increase, the average premium for the least expensive PPO or other silver-level open access plan grew from $291 to $339, an 17 percent jump. Read more »

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