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Thursday, Feb 24 2022

Full Issue

Federal Judge Blocks Part Of HHS Surprise Billing Rule

In a win for doctors, a federal judge in Texas on Wednesday struck down part of the Biden administration’s regulations, taking issue with its mediation process for hospitals and doctors and insurers to settle disputes over out-of-network medical bills.

Stat: Federal Court Strikes Down Part Of HHS Surprise Billing Rule 

A federal court on Wednesday struck down the Biden administration’s interpretation of a controversial part of the federal law banning surprise medical bills. Health care providers have filed several lawsuits challenging how the Department of Health and Human Services created a mediation process for hospitals and doctors and insurers to settle disputes over out-of-network medical bills. A federal court judge in Texas sided with Texas Medical Association, a trade association representing more than 55,000 physicians, and decided that HHS was mistaken in its decision to instruct mediators to give rates insurers and providers contracted with in the past extra weight compared with other factors. (Cohrs, 2/23)

The Hill: Judge Strikes Down Part Of Biden Surprise Billing Rules In Win For Doctors

The ruling leaves in place the protections for patients against getting bills for thousands of dollars in situations such as going to the emergency room and later finding out one of the doctors was not covered by their insurance. But it strikes down part of the regulations that govern how much insurers will pay doctors once the patient is taken out of the middle. The ruling, from Judge Jeremy Kernodle, an appointee of former President Trump, is the latest in a long-running fight over the details of the rules. (Sullivan, 2/23)

Also —

The Washington Post: More African Americans Have Gained Health Insurance Following Adoption Of The Affordable Care Act, HHS Report Finds

The percentage of Black Americans who lack medical insurance has dropped substantially since the adoption of the Affordable Care Act, but that progress largely depends on where people live, according to a new report from the Department of Health and Human Services. People in pockets of the country remain unable to benefit from the law that reshaped the nation’s health-care system because many Southern states have refused to participate in key provisions that expanded coverage to millions of Americans who had little or no access to medical insurance. (Johnson, 2/23)

The Wall Street Journal: Medicare Proposal On Alzheimer’s Drug Draws Criticism From Drugmakers

Drugmakers and patient advocacy groups are pushing back against a federal proposal to cut off most Medicare payments for Biogen Inc.’s new Alzheimer’s drug, contending the healthcare agency is overstepping the bounds of its expertise. The Centers for Medicare and Medicaid Services proposed last month to limit coverage of Biogen’s drug Aduhelm to patients enrolled in clinical trials sanctioned by the agency. The proposal would also apply to similar drugs still in development and not yet approved, including those from Eisai Co. , Eli Lilly & Co., and Roche Holding AG , that work by reducing amyloid protein, a hallmark of Alzheimer’s, in the brain. (Walker, 2/23)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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