A new study released Thursday by the Rand Corp. showed that Hoosiers covered by employer health plans paid Indiana hospitals nearly three times—or 292%—of what Medicare would have paid for the same procedures.
20 Indiana hospitals docked for high rates of patient injuries, infections
The fines are one way Medicare is clamping down on hospitals, using penalties and incentives authorized by the Affordable Care Act to push for better outcomes, fewer safety problems and a lower number of readmissions.Read More
Insurers push hard to win Medicare Advantage customers
In Indiana last year, dozens of insurers across the state rolled out plans hoping to get a sizable piece of the fast-growing market.Read More
Feds accuse Community Health of submitting false claims to Medicare
The Justice Department said the financial arrangements were outlined in a whistleblower suit brought by Thomas Fischer, who served as Community Health’s CFO from 2005 until his sudden exit in 2013. In a separate suit, Fischer claimed he was fired in retaliation for questioning possibly illegal practices.Read More
Prevounce Health, which launched in 2019 in Los Angeles, relocated its operations to Indianapolis last fall and just landed $4.5 million in investment funding which the company says will help it expand and double its workforce in coming months.
Thursday’s coverage decision illustrates the impact that a single medication can have on the budgets of individuals and taxpayers.
Starting in early spring, up to eight free tests will be available each month to people who have Medicare’s “Part B” outpatient benefit, which about 9 in 10 enrollees sign up for.
Medicare officials stressed Tuesday that they did not take cost into account in the coverage decision, but rather whether Aduhelm is “reasonable and necessary” for treating Alzheimer’s patients enrolled in the program.
U.S. health secretary Xavier Becerra on Monday ordered Medicare to reassess a big premium increase facing millions of seniors this year, attributed in large part to a pricey new Alzheimer’s drug with questionable benefits.
The biggest policy change—a system for Medicare to negotiate prices for prescription drugs—won’t begin to deliver lower costs until 2025, and then only for a selected set of 10 medicines, as well as insulin products.
For the 10th straight year, the Centers for Medicare & Medicaid Services is using the pressure of lower reimbursements to get hospitals to improve their numbers and cut down on the revolving door of readmissions.
The so-called “means test” is drawing internal opposition from many Democratic lawmakers, as well as advocacy groups for older people, like AARP.
“A cut [in drug prices] like is being proposed would have about a 40% reduction in our U.S. revenues,” Lilly CEO David Ricks said in a television interview this week with Gerry Dick on Inside Indiana Business, a division of IBJ Media.
President Joe Biden stepped up his battle over drug costs on Thursday, calling on Congress to pass legislation that would let Medicare negotiate directly with pharmaceutical manufacturers and penalize drugmakers that increase prices faster than inflation.
Separately, Dr. Aaron Kesselheim of Harvard University became the third member of an FDA advisory panel that opposed the drug to step down over the decision to approve it.
A new study released Friday by the Rand Corp. found that Hoosiers covered by employer health plans paid Indiana hospitals three times what Medicare would have paid for the same procedures, exceeding the national rate of disparity.
A Health and Human Services Department official called the report on Seema Verma a “political smear” by “far left politicians.” Before she headed to Washington, Verma was a consultant to former Gov. Mike Pence and designed the Healthy Indiana Plan.
Indiana’s weakest and often smallest hospitals, usually with just a few dozen beds, might be only months from beginning the process of shutting their doors, industry leaders say.
Twenty-four Indiana hospitals will be docked by the Centers for Medicare & Medicaid Services—the highest number since the program began six years ago.
The legislation has no chance of passing the Republican-controlled Senate, and the White House has issued a veto threat. Still, Democrats saw a victory in the message their bill sends to voters.
As a hammer to force companies to negotiate, House Speaker Nancy Pelosi would impose steep sales taxes on the medications at issue. Overall, budget analysts estimated the legislation would cut industry revenues by $500 billion to $1 trillion over 10 years.