Modern Healthcare Staff Mara Lee Former Reporter See All Staff Page Recent Stories Left in the lurch: Ongoing uncertainty is taking a toll on health insurers Even though Congress shifted its focus from bulldozing the Affordable Care Act to stabilizing the troubled individual market in the short term, big questions remain. Maine residents hope ballot box will do what legislators couldn't: Expand Medicaid to more low-income adults Advocates for Maine's Medicaid expansion believe their side has more political energy going into November election—and this time, the governor can't veto the initiative. Momentum builds for bipartisan compromise on ACA fixes Senate health committee Chairman Lamar Alexander continues to look for areas of bipartisan agreement that don't cost more money and can settle the troubled individual insurance market as he faces increased calls to guarantee cost-sharing subsidies. Lawmakers look for compromise to stabilize health insurance markets The chairman of the Senate health committee says he's looking for short-term fixes that Republicans and Democrats can agree on in the next 10 days so Congress can influence ACA insurance rates for 2018. What to watch for as Senate healthcare hearings get underway Health insurers, providers and others will be listening closely to Senate committee hearings this week to get a sense of what a potential bill will look like and how it will impact the individual insurance market. Cutting into cost growth without an ACO Employers are still lukewarm on the concept of ACOs, and a Georgia flooring company has found success limiting cost growth without one. Senators to hear testimony on individual market As the Heath, Education, Labor and Pensions Committee races to produce a market stabilization bill, they'll hold the first two of four hearings on what should be done for the individual market. Experts: States can adjust to lower CHIP match if they have time to prepare Insiders say Congress will not pull the enhanced match for CHIP, at least not next year. But it's not clear if legislators can get funding finalized next month. HHS ordered to explain Medicare outlier payment formula HHS' outlier payment program has been subject to scrutiny after more than 100 hospitals manipulated data to score more reimbursement money for their exceptionally expensive patients. Progressives, led by Bernie Sanders, want to shift healthcare reform debate Single-payer is likely a long way off in the U.S., but progressives want to talk about how it could be done. UMass Memorial withdrawing from Medicaid ACO initiative UMass Memorial, one of six provider groups in Massachusetts' Medicaid ACO pilot, will not continue with the upcoming larger initiative. DOJ, Mylan finalize $465 million EpiPen Medicaid settlement Mylan allegedly misclassified EpiPens as a generic drug, which may have cost the government up to $1.27 billion in lost Medicaid rebates, according to federal estimates. Changes to 340B drug discount rule delayed until July 2018 A rule that would set new ceiling prices in the 340B drug discount program has been delayed until mid-2018 while HHS considers alternative regulations. CBO: End of CSRs would add to federal deficit The CBO says that ending CSR payments to insurers would cost the federal government more than continuing to pay them, because insurers would hike premiums, and subsidies would then rise as well. CBO to weigh in on cost-sharing reduction payments The Congressional Budget Office is set to release a report detailing what could happen to insurance markets if the federal government stops making cost-sharing reduction payments. Load More Sponsored Content