Health Care archive- Page 4 of 5

Encompass Health: HHS OIG Report Highlights High Rate of Medicare Advantage Denials for IRF Stays

A report published today by the Health and Human Services Office of Inspector General (HHS OIG) indicates that the three largest Medicare Advantage Organizations (MAOs) are denying requests for stays at inpatient rehabilitation facilities (IRFs) at an outsized rate. The report raises...

Jun 11, 2026 Read Now >

Health Care Weekly: SCOTUS Sides with Generic Drugmaker in Skinny Labeling Case; FDA, Congress Aim to Speed Up Investigational New Drug Applications; OpenEvidence Says Doximity Misled Pharmaceutical Advertisers; CMS to Launch GLP-1 Bridge Program in July; FDA 483s

SCOTUS rules in favor of generic drugmaker in “skinny labeling” case. On June 4, the Supreme Court issued a unanimous opinion to reverse a previous Federal Circuit ruling in a patent case filed by drugmaker Amarin (AMRN) against its generic competitor Hikma, ruling that Hikma had not...

Jun 10, 2026 Read Now >

Four Years After OTC Hearing Aid Rule, Competition in Hearing Aid Market Remains Limited Due to Deep Vertical Integration, Sources Say

In 2022, the Food and Drug Administration finalized a rule expected to increase competition in the hearing aid market by giving patients with mild-to-moderate hearing loss access to over-the-counter hearing aids, a potentially cheaper alternative to expensive prescription...

Jun 05, 2026 Read Now >

Health Care Weekly: Whistleblower Suit Accuses Corcept of Off-Label Marketing; CMS Finalizes Long-Awaited Rule on NSA Dispute Process; Democrats Seek Congressional Disapproval of WISeR; FDA Publishes More Draft Guidance on Reducing Animal Testing; Optum Close to Settling FTC Insulin Case; MultiPlan, Insurers Face Price-Fixing Lawsuit in AZ; FDA 483s

Recently-unsealed whistleblower lawsuit accuses Corcept of off-label marketing. Originally filed in February 2017 on behalf of the United States of America, almost 30 states, and unnamed insurance policyholders, the just-unsealed lawsuit alleges that Corcept (CORT) engaged in off- label...

Jun 03, 2026 Read Now >

Medline: Company Receives Warning Letter from FDA Over Bacterial Contamination in Infant Surgical Wipes

Earlier today, the FDA published a warning letter that the agency sent to Medline (MDLN), citing the company for several systemic failures in how it has responded to bacterial contamination in its ReadyPrep Chlorhexidine Gluconate (CHG) antiseptic wipes, which are used to prepare...

Jun 02, 2026 Read Now >

The European Antitrust Agenda: Von der Leyen Urged to Greenlight Google Penalty; JD.com Stands Against FSR Probe

Welcome to The European Antitrust Agenda, brought to you by Europe Executive Editor Javier Espinoza and Senior Correspondents Lydia O’Neal, Barbara Pianese, Joanna Sopinska and Catherine Stupp. This week, we look at fresh pressure on the European Commission to move ahead with a fine...

Jun 02, 2026 Read Now >

Medline: FDA, Industry Experts Raise Concerns Over Company’s Oversight of Contract Manufacturers and Ability to Monitor Device Malfunctions

A Capitol Forum investigation has found that poor oversight of its suppliers and post-market surveillance practices by the medical device company Medline (MDLN) is leading to patient harm and delayed recalls of dangerous products. Over the last several years, FDA inspectors have...

Jun 01, 2026 Read Now >

Universal Health Services: Sexual Assaults and Runaways Persist at South Carolina Facility Despite Federal Sanction

This article contains descriptions of sexual assault. Last year, government inspectors placed multiple immediate jeopardies (IJs) on Three Rivers Behavioral Health, a psychiatric facility operated by Universal Health Services (UHS) in West Columbia, South Carolina, after finding the...

May 26, 2026 Read Now >

DOJ Launches Criminal Antitrust Probe into Claritev

DOJ’s antitrust division has launched a criminal price-fixing investigation into Claritev (CTEV), previously known as MultiPlan, a pricing intermediary that major health insurers use to set reimbursement rates for out-of-network medical claims, sources familiar with the matter...

May 14, 2026 Read Now >

The European Antitrust Agenda: Merger Guidelines Offer Clarity to Startup Buyers and Consider Workers’ Rights

Welcome to The European Antitrust Agenda, brought to you by Europe Executive Editor Javier Espinoza and Senior Correspondents Lydia O’Neal, Barbara Pianese, Joanna Sopinska and Catherine Stupp. This week, we look at the leaked draft of the EU’s forthcoming merger guidelines. A boon...

Apr 28, 2026 Read Now >

Medline: Company Apparently Did Not Disclose Systemic Problems Identified in Multiple FDA Inspections in Year Prior to IPO

Last December, Medline (MDLN), one of the largest suppliers of medical and surgical products in the country, went public in the biggest IPO of the year, raising over $6 billion. In the 12 months prior to the IPO, Medline received four Form 483 inspection...

Apr 16, 2026 Read Now >

CMS Policy: Proposed 0.09% Medicare Rate Appears More Likely to Climb Due to Technical Changes Than CMS Backing Down on Risk Adjustment Policies

Last week, the Centers for Medicare and Medicaid Services (CMS) published an advance notice proposing both technical and policy-related changes to the Medicare Advantage (MA) and Medicare Part D payment methodologies that would, on average, result in a nearly flat rate increase of 0.09%...

Feb 03, 2026 Read Now >

Oral Tirzepatide Ads Could Conflict with Meta’s Ad Policy, Raise Other Legal Questions

In December, the attorneys general of 35 U.S. states and territories wrote a letter calling on Meta to address “the surge of misleading marketing for weight loss products on Meta’s platforms,” particularly for compounded GLP-1 products, which do not have Food and Drug Administration...

Jan 20, 2026 Read Now >

Congressional Appropriations Bill Directs FTC to Submit Reports Detailing Competition in Retail, Pharmacy, Grocery, and Fire Trucks

The latest funding package for the FTC directs the agency to submit reports to Congress on retail competition in the food, pharmacy and grocery sectors as well as consolidation in the fire truck market. Those requests come...

Jan 13, 2026 Read Now >

Capitol Forum’s Tech Policy 2026 Predictions: Brinkema Will Break Up Google’s Ad Tech Monopoly, DOJ and/or States Will Appeal Google Search Remedy, Open AI Will Take Feud with Google to Europe, Big Tech Will Push for Trade Policy ‘Get Out of Jail Free Card’

As part of our tech policy coverage, we are launching our annual predictions on some of the most meaningful events expected to take place in 2026, which we will track regularly throughout the year. To discuss these predictions with Executive Editor Teddy Downey, please join us for a...

Jan 08, 2026 Read Now >

Inspire Medical Systems: Palmetto Removes Lucrative Billing Code for Hypoglossal Nerve Stimulation; Decision Means No Remaining Medicare Administrative Contractors Recognize Code

The Medicare Administrative Contractor (MAC) Palmetto removed the CPT code 64568 from its list of approved billing codes for Hypoglossal Nerve Stimulation (HGNS), according to an update posted yesterday to the Medicare Coverage Database. The move follows the recent updates by the MACs...

Jan 02, 2026 Read Now >

Inspire Medical Systems: Following Other MACs, WPS Removes Lucrative Billing Code for Hypoglossal Nerve Stimulation

The Medicare Administrative Contractor (MAC) WPS removed the CPT code 64568 from its list of approved billing codes for Hypoglossal Nerve Stimulation (HGNS), according to an update posted today on the MAC’s website. The move follows the recent updates by the MACs Noridian and CGS that...

Dec 29, 2025 Read Now >

Health Care Weekly: Zynex Files for Bankruptcy; Most FTC-Challenged Patents Delisted; TX AG Sues Epic; UnitedHealth Contract Dispute; Analysis of FDA Draft Guidance on Animal Testing; Report on Utilization Management in Traditional Medicare

Zynex files for bankruptcy. Yesterday, Zynex Medical (ZYXI) announced that it was filing for Chapter 11 bankruptcy in the Southern District of Texas. The announcement comes after a turbulent year for the company during which the Defense Health Agency (DHA), Zynex’s largest source of...

Dec 17, 2025 Read Now >

Inspire Medical Systems: Medicare Administrative Contractors Working on ‘Consensus Approach’ to Resolve Billing Issue

At least three Medicare Administrative Contractors (MACs) are working on a “consensus approach” to resolving a billing dispute that could see some MACs paying much more than other MACs for hypoglossal nerve stimulation (HGNS) procedures, The Capitol Forum has learned. The rest of this...

Dec 15, 2025 Read Now >

MAUDE Monthly: Beta Bionics Reports Remain High; Dexcom Says It Has Fixed Sensor Issues; FDA Warns Patients Against RF Microneedling; Pyxis Problems Persist Despite Over a Dozen Recalls; Boston Scientific Spinal Implants Breaking During Surgery; Update on Dentsply Sirona Class Action

The information contained in this report is compiled from the FDA’s Manufacturer and User Facility Device Experience (MAUDE) database. The MAUDE database contains reports of deaths, injuries, and malfunctions relating to the use of medical devices and is updated monthly with reports...

Nov 13, 2025 Read Now >

Ski Gear Maker Tecnica Confirms EU Antitrust Raid of Austrian Facility

Tecnica Group, the Italian owner of the Rollerblade inline skates brand, was among the companies raided by the European Commission as part of a cartel investigation into the ski equipment sector yesterday, a company spokesperson told The Capitol Forum. Commission representatives visited...

Oct 21, 2025 Read Now >

Health Care Policy: Analysis of Potential Policy Outcomes, Industry Effects of MAHA’s Efforts to Target Direct-to-Consumer Pharma Ads

The White House’s Make America Healthy Again (MAHA) Commission, led by Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., is expected to release a “Make Our Children Healthy Again” policy plan tomorrow. The strategy may include a crackdown on...

Sep 08, 2025 Read Now >

Caris Life Sciences: A Closer Look at Opportunities, Roadblocks for Widespread Adoption of AI-Based Precision Oncology Tools

Caris Life Sciences (CAI) earned Food and Drug Administration (FDA) approval for MI Cancer Seek, a tool that runs genetic sequencing on tumor tissue, for use as a companion diagnostic—atest that helps identify the best course of treatment for a patient—in November 2024. Since then,...

Sep 02, 2025 Read Now >

Dozens of Federal Judges Attended Antitrust Seminars Hosted by Big Tech-Funded Group, Records Show

Dozens of federal judges attended seminars in idyllic locales like Hawaii and Portugal held by a George Mason University (GMU) law school organization that received Big Tech funding, a Capitol Forum review of public records found. The university’s Antonin Scalia Law School, one of the...

Aug 13, 2025 Read Now >

Encompass Health: Facilities Across the Country Misusing Neurological Diagnosis to Increase Medicare Payments; Conduct Echoes Those Highlighted in 2019 DOJ Settlement

In 2019, Encompass Health (EHC), the country’s largest operator of inpatient rehabilitation facilities (IRF), entered into a settlement with the Department of Justice for $48 million to resolve allegations that its hospitals falsely diagnosed patients to increase Medicare payments and...

Jul 25, 2025 Read Now >

HPE/Juniper: As Fight Between DOJ Leadership and Antitrust Division Broils, Tunney Act Proceeding Looms

After DOJ’s suit to block HPE’s (HPE) $14 billion acquisition of Juniper Networks (JNPR) culminated in a highly unusual settlement, the consent decree faces one last barrier to becoming final: Tunney Act review by U.S. District Judge Casey Pitts. That’s typically a rubber stamp....

Jul 24, 2025 Read Now >

Novo Nordisk: Company Did Not Report or Investigate Deaths Potentially Caused by Ozempic

Novo Nordisk (NVO) did not report multiple deaths that may have been caused by its blockbuster weight loss drug Ozempic to the FDA, according to an agency inspection report obtained by The Capitol Forum through a Freedom of Information Act request… The rest of this article is...

Jul 15, 2025 Read Now >

Prestige Consumer Healthcare: Subsidiary Kept Mold-Contaminated Enemas on Market and Declined to Investigate Source of Outbreak, According to FDA Inspection

Between 2023 and 2025, Fleet, a subsidiary of Prestige Consumer Healthcare (PBH) that manufactures enemas and suppositories, received several complaints that its adult and pediatric enemas were being shipped to customers with visible signs of mold. Despite these complaints, however, the...

Jul 11, 2025 Read Now >

Inspire: Company Files Patent Lawsuit Seemingly to Delay Competition; A Closer Look at the Patents at Issue and Potential Paths Forward

Nyxoah, a Belgian company whose implantable sleep apnea device, Genio, has been on the market in Europe since 2020, plans on launching its device in the U.S. upon earning final approval from the Food and Drug Administration (FDA)—a decision company executives say is...

Jul 11, 2025 Read Now >

Merger Monthly: After Novel Omnicom/Interpublic, HPE/Juniper Remedies, is Everything Settleable?; Outlook for Key Transactions Including Getty/Shutterstock, Mars/Kellanova, and UnitedHealth/Amedisys

In the months after Inauguration Day, the Trump administration’s merger policy appeared to be slowly but surely rounding into form: To wit, meaningful continuity from the Biden administration (retaining the 2023 Merger Guidelines and updated HSR Form), coupled with substantive pull back...

Jul 10, 2025 Read Now >

Medicaid Policy: Approval Timeline for Tennessee’s 1115 Waiver Amendment Remains Uncertain, Could Be Complicated by Forthcoming Legislative Changes

Tennessee is waiting on the Centers for Medicare and Medicaid Services (CMS) to approve an amendment to its Medicaid managed care program, TennCare III, that would authorize additional payments to hospitals that meet certain access and quality improvement benchmarks. While it remains...

Jun 27, 2025 Read Now >

Universal Health Services: Problematic Hospital in California Did Not Consistently Report Patient Abuse to Regulators Because It ‘Would Be Reporting All the Time,’ Administrators Told State

Del Amo Behavioral Health, a psychiatric hospital in Torrance, California, owned by Universal Health Services (UHS), is not reporting severe physical and sexual assault of patients in its care, a Capitol Forum investigation has...

Jun 25, 2025 Read Now >

Influential Conservative Think Tank’s President Touts Legislation Targeting ACA, Medicaid Enrollment and Spending at House Hearing, Says Expansion Match Rate is Still a Problem

Brian Blase, the president of a conservative health policy group with links to the Trump administration, called on Congress at a June 25 House Budget Committee hearing to crack down on enrollments in the Affordable Care Act (ACA) Marketplace, de-incentivize states from expanding their...

Jun 25, 2025 Read Now >

FTC Advertising Collusion CIDs Target Nonprofits, Raising Jurisdictional Questions

The FTC Bureau of Competition’s move last month to issue lengthy civil investigative demands (CIDs) to more than a dozen media tracking and advertising organizations—many organized as nonprofits—raises a host of important...

Jun 10, 2025 Read Now >

UnitedHealth/Amedisys: DOJ, Parties Engaging in Serious Talks to Settle Case; Number of Divestitures Under Discussion

Prospects are brightening for UnitedHealth Group’s proposed takeover of Amedisys as DOJ and the parties’ representatives engage in serious negotiations to settle the department’s suit to block the $3.3 billion deal, sources familiar with the matter...

Jun 10, 2025 Read Now >

The Asia Antitrust Agenda: SAMR Fines Pharma Suppliers for Price-Fixing; ACCC Kicks Off Omnicom/IPG Review; China’s Regulators Warn Food-Delivery Platforms Over Competition Concerns; Indian Supreme Court Issues Landmark Ruling in Abuse of Dominance Case

SAMR fines four pharmaceutical suppliers 354 million yuan for price-fixing. The Tianjin branch of China’s State Administration for Market Regulation (SAMR) announced on May 9 that it had levied a total of 354 million yuan ($49 million) in penalties on four pharmaceutical suppliers for...

May 19, 2025 Read Now >

The Trade Desk: Adtech’s Persistent Identifier Can Be Tied to Potentially Sensitive Information as Lawsuits Allege Unfair Data Collection Practices

Adtech company The Trade Desk (TTD) enables advertisers to target millions of individuals based on unique persistent identifiers that can potentially be associated with a host of sensitive information, from precise geolocation to data capable of inferring a consumer’s gender, ethnicity,...

May 12, 2025 Read Now >

Roper Technologies’ Strata’s Information Sharing Practices, Tools for Health Care Providers, Could Bring Antitrust Scrutiny

Health care providers can access rivals’ detailed output data and receive customized pricing recommendations through Roper Technologies subsidiary Strata Decision Technology’s software tools, according to company marketing materials reviewed by The Capitol...

May 01, 2025 Read Now >

FDA’s Plan to Reduce Drug Testing on Animals May Take Longer Than Three to Five Years, But Lays Out Clear Blueprint for Phasing in Alternative Technologies, Scientists Say

In line with an ongoing, bipartisan push in Congress to reduce the pharmaceutical industry’s reliance on animal testing, the Food and Drug Administration (FDA) published a roadmap on April 10 laying out policy steps to transition drugmakers to non-animal methods for testing drug...

Apr 17, 2025 Read Now >

GTCR/Surmodics: Judge’s Record of Holding Companies Accountable Favors FTC; Agency, Companies Will Need to Focus on Details

After a legal career filled with civil and voting rights cases, U.S. District Judge Jeffrey Cummings has moved into antitrust law in a big way. He’s presiding over the FTC’s suit to block GTCR’s proposed buyout of medical-device coatings maker Surmodics (SRDX) and private litigation...

Apr 11, 2025 Read Now >

Universal Health Services: Hospital System Could Be at Risk if Congress, States Curb Supplemental Medicaid Payments

Universal Health Services (UHS), a health care management company that runs acute care and behavioral health facilities, could face financial risk if proposed policies targeting Medicaid supplemental payments—state reimbursements to hospitals that exceed the baseline Medicaid...

Apr 09, 2025 Read Now >

LiveRamp: Company Hosts Marketplace Selling Datasets that Target Millions of Americans Based on Sensitive Information, Military Status

Data broker LiveRamp Holdings, Inc. (RAMP) operates a vast digital marketplace that exchanges the personal information of hundreds of millions of individuals grouped into highly specific audience “segments”—many of which include potentially sensitive information denoting...

Apr 09, 2025 Read Now >

LiveRamp: Company Hosts Marketplace Selling Datasets that Target Millions of Americans Based on Sensitive Information, Military Status

Data broker LiveRamp Holdings, Inc. (RAMP) operates a vast digital marketplace that exchanges the personal information of hundreds of millions of individuals grouped into highly specific audience “segments”—many of which include potentially sensitive information denoting everything...

Apr 08, 2025 Read Now >

FTC’s Ferguson, DOJ’s Slater Signal Less Aggressive Merger Approach Than Biden Predecessors, Openness to Remedies

FTC Chairman Andrew Ferguson and DOJ antitrust chief Gail Slater today indicated they would take a less aggressive approach to merger enforcement than their Biden administration predecessors and be more willing to entertain remedies. “Healthy pro-competitive M&A that allows American...

Apr 02, 2025 Read Now >

Universal Health Services: Review of State Inspection Records Finds Conduct That Could Result in Additional Lawsuits Against the Company, Potentially Resulting in Large Judgments

Last year, a jury awarded $535 million in damages to the family of a 13-year-old girl that was sexually assaulted during a 2020 stay at the Pavillion Behavioral Health System, an Illinois residential treatment program owned and operated by Universal Health Services...

Mar 25, 2025 Read Now >

Dexcom: FDA Warning Letter States Company Made Changes to Continuous Glucose Monitors Without Necessary Approval from Agency; Letter States Company Commits to Ceasing Distribution of Sensors with Design Changes that Caused ‘Higher Risks for Users’

The FDA has published a warning letter it sent to Dexcom (DXCM) earlier this month regarding issues with the manufacturing and validation of its continuous glucose monitors (CGMs) that affected their accuracy. The warning letter states that Dexcom failed to gain necessary approvals for...

Mar 25, 2025 Read Now >

Teva: Drugmaker Requests Delisting of Inhaler Patents from Orange Book in Response to Court Order; Boehringer Ingelheim, Novo Nordisk Have Also Asked FDA to Pull Disputed Drug-Device Patents

Teva (TEVA), the drugmaker at the center of the Federal Trade Commission’s efforts to curb the improper listing of patents in the Food and Drug Administration’s Orange Book, has asked the FDA to delist five patents associated with its asthma inhaler, ProAir HFA, in response to a...

Mar 24, 2025 Read Now >

Labor Thursday: Litigation Tracker Updates; Labor Board Member Finds Receptive Judge in Termination Case Against Trump, Teeing Up Appeal

Labor Thursday is a weekly overview of competition and labor market issues and includes our analysis of the timing and priorities of the key agencies overseeing enforcement and rulemaking, including the Federal Trade Commission, Justice Department, and National Labor Relations Board. This...

Mar 06, 2025 Read Now >

GTCR/Surmodics: Facing Potential FTC Suit, Companies Allow Brief Review Extension to Early Next Month

Facing a potential FTC suit against GTCR’s planned $627 million Surmodics (SRDX) buyout, the companies have agreed to extend the antitrust review into early next month and continue discussions with the agency, sources familiar with the matter...

Feb 27, 2025 Read Now >

Hims & Hers Health: Questions Remain About Compounding Viability Post Resolution of Semaglutide Shortage

The Food and Drug Administration announced on Feb. 21 that the years-long shortage of semaglutide, the active ingredient in Novo Nordisk’s blockbuster weight-loss injections Ozempic and Wegovy, had been...

Feb 21, 2025 Read Now >

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