Thirty states have been conducting Medicaid and CHIP automatic renewals incorrectly, leading to many individuals being wrongly removed from coverage. Because of this, nearly 500,000 children and other individuals will have their coverage reinstated.

HHS released a new proposed rule to update nearly 50-year old regulations protecting people with disabilities from discrimination while seeking healthcare. With its new proposal, HHS is amending the regulations to be clearer in their language, as well as more aligned with the Americans with Disabilities Act, the Americans with Disabilities Amendments Act and amendments to the Rehabilitation Act.

Novartis became the seventh drugmaker to legally challenge the White House’s Medicare drug pricing negotiation program. The company filed its lawsuit three days after HHS announced the first 10 drugs that were selected for the program — its heart failure medication Entresto was one on the list. HHS can expect to face more lawsuits from the manufacturers of the 10 drugs it named last week, experts have warned.

Vanderbilt University Medical Center is under federal investigation after it turned transgender patients’ medical records over to Tennessee’s attorney general. HHS launched the investigation a couple weeks after two VUMC patients filed a class-action lawsuit against the hospital for releasing their records to the attorney general.

HHS issued an alert warning providers about Rhysida, a ransomware gang that recently begun launching attacks on healthcare organizations. The group deploys its ransomware primarily through phishing attacks or the exploitation of legitimate cybersecurity tools.

CMS recently proposed a $9 billion lump sum payment to remedy illegal payment cuts for 340B drugs from 2018 to 2022. In general, hospital groups have reacted positively to the fact that 340B providers will receive lump sum payments but have expressed concern about CMS’ methods for maintaining budget neutrality with this plan.

Forty-two safety net hospitals recently sued HHS, alleging that the Medicare program “unlawfully withheld and unreasonably denied” DSH payments for decades. The plaintiff hospitals said that HHS’ failure to recalculate DSH payments have cost them “tens of millions of dollars in funds that should have been paid to them many years ago.”

Hospitals, clinics, nursing homes and other providers collected billions in government aid during the pandemic. Federal auditors may soon come knocking to ensure the money was spent correctly.

The FBI, CISA and HHS have all recently issued warnings about the dangers associated with the Royal Ransomware gang. Since approximately September of last year, cybercriminals have been using a Royal ransomware variant to compromise organizations across the U.S., many of which have been healthcare providers.

David Finn, CHIME Association Executive Healthcare and Information Sector, lead of the cybersecurity pavilion initiatives at ViVE 2023, does not mince words. With ransomware attacks surging to an all time high this month, Finn said in an interview that security is no longer a defensive posture; we are engaged in a war.

The U.S. Department of Health & Human Services announced three models Tuesday that will be tested by the CMS Innovation Center and aim to lower prescription drug costs. The models, which include access to $2 generic drugs, build on the Inflation Reduction Act of 2022.

Under the proposed new rule, employers are no longer able to be exempt from covering contraception due to moral convictions, but religious exemptions still remain. It’s an important move from the government during the reproductive health crisis, one advocate said.

The uninsured rate declined to 10.5% in 2021 from 11.1% in 2019, according to a recent report from HHS. Some of the largest gains in coverage were among demographic groups that historically have had higher uninsured rates, such as younger adults, Latino individuals, American Indian/Alaska Natives and non-English speaking adults.

About 11.5 million people have selected a health plan through the ACA Marketplace as of December 15. This is 1.8 million people more than the same period last year, representing an 18% increase, CMS said.

In 2022, the healthcare sector is on track to meet or exceed the more than 50.4 million patient records that were breached last year. As we look ahead to 2023, increasing cybersecurity budgets will be a necessity for healthcare organizations, despite their tight financial circumstances.

This represents a 17% increase in total ACA plan selections — both through HealthCare.gov and state-based Marketplaces — compared with last year, CMS said. Enrollment through the federal HealthCare.gov has especially seen a rise of 40% from the same period last year.

Latino and Black communities saw the largest increase in Marketplace enrollment. HHS credited the rise partially to improved outreach and education efforts.

Cybercriminals are weaponizing the same tools that healthcare providers use to operate and maintain secure IT systems, HHS warned in a recent report. Providers can protect themselves by having a firm grasp of what their IT environment looks like, as this may help them spot any suspicious security tool commands.

From July 2021 to July 2022, 1,216 prescription drugs saw price increases that soared past the inflation rate of 8.5% for that time period, one HHS report showed. Another reported that in 2021, the American healthcare system spent $603 billion on prescription drugs, of which $421 billion was spent on retail drugs.

Based on historical data, about 17.4% of Medicaid/CHIP enrollees will leave the program once the Covid-19 public health emergency ends. This is because the continuous enrollment requirement, which prohibited states from disenrolling Medicaid participants, will halt.

The federal government has established various departments and initiatives to promote cybersecurity among healthcare organizations, but experts say these efforts require more cross-agency collaboration in order to be effective. Most urgently, many cybersecurity experts are calling for the FDA to spend more time collaborating with other federal agencies on cybersecurity recommendations for medical devices.

The American Medical Association, American Hospital Association and other provider groups are suing the Department of Health and Human Services over a small but important detail of how it is implementing surprise billing legislation. They argue that the arbitration process for unresolved disputes currently favors insurers.

A study by the U.S. Department of Health and Human Services found that telehealth use increased 63-fold during the pandemic. But it also found significant disparities in telehealth use between urban and rural residents. 

Of the billions of dollars provided by the government to support providers during the pandemic, $11.7 billion has been allocated but not spent, $7.1 billion has not been allocated and $8 billion has been returned for various reasons, including that the organization recovered faster than expected.

Per the new interim final rule, parties that cannot agree on out-of-network payment rates must enter into a 30-day open negotiation period. If that fails, an independent entity will be engaged to make the final decision.

HHS wants insurers offering individual and short-term, limited-duration coverage to disclose to members the rates they pay to brokers who help people select health plans. The government also wants to collect air ambulance data to help curb the high and unexpected costs that arise from these services.

The report, released by Kaiser Family Foundation and the Peterson Center on Healthcare, details the high cost of Covid care for the unvaccinated. In fact, the analysis indicates the figure could be even higher than $2.3 billion, as the authors did not take into account the cost of outpatient treatment for Covid-19.

The permanent injunction prevents HHS from interpreting a section of the ACA, which bans discrimination, to include gender identity and pregnancy status. This move prohibits the federal agency from penalizing religious providers for refusing to perform or provide insurance coverage for gender-transition surgeries and abortions.

Provider organizations accounted for 73% of all data breaches reported to the HHS in the first six months of 2021, impacting about 22.7 million individuals overall, a new report shows. This represents a 185% jump in individuals affected compared to the same period last year.

Spearheaded by the Departments of Justice, and Health and Human Services, efforts to investigate and prosecute healthcare fraud resulted in the government recovering billions, including about $2.1 billion for the Medicare Trust Funds.