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Myriad Genetics, Inc., announced today that the Medicare Administrative Contractor (MAC) that has jurisdiction over most molecular diagnostic tests has issued its draft notice on how Medicare will provide reimbursement for Prolaris, a test that Myriad has developed to guide treatment decisions in prostate cancer.

Despite continued Republican opposition to the Affordable Care Act, sentiment is shifting from repeal to replace. Still, the fact that open enrollment on HealthCare.gov begins after the midterm elections does not seem like a coincidence to the GOP.

While the current approved immuno-oncolgy drugs have been approved for melanoma, Roche has also been evaluating their new molecule in triple-negative breast cancer. The results will be presented at the San Antonio Breast Cancer Symposium.

A majority of Americans covered by the Affordable Care Act are expecting to change plans for 2015, which may be a smart move, according to industry experts. People who simply re-enroll may not realize they are no longer among the lowest costing plans, which will affect how much their subsidies pay for.

The regimen, based on reprogramming the patient's immune T cells to attack the cancer cells, led to the disappearance of cancer in 90 percent of patients, according to a study published in the New England Journal of Medicine.

Legal reforms that enact stronger protections against malpractice claims do not necessarily reduce defensive care, according to a new study by the RAND Corporation published in the New England Journal of Medicine.

Massachusetts health officials over-billed Medicaid for almost $106 million by filing claims from as far back as 1988 as current expenses, according to an HHS inspector general's report.

The strict rules of the Meaningful Use (MU) program are preventing physicians from participating, according to the American Medical Association, which is calling for more flexibility and some relief from penalties.

A blog published by The Commonwealth Fund points to digital technology glitches being responsible for slower policy adoption by several state exchanges. But states are fixing their technology glitches and also setting examples for other states to follow, say the authors.

After Roche saw 2 product rejects a few weeks back from NICE, based on a value argument, Celgene is in a similar boat with it's multiple myeloma drug pomalidomide.

Health officials from CDC and the state of Texas are reeling in the wake of today's report that a second nurse at the Texas hospital that treated Ebola patient Thomas Eric Duncan has tested positive for the virus. The news came while health leaders were still trying to determine how 26-year-old nurse Nina Pham contracted Ebola while caring for the first patient diagnosed with the disease on US soil. Meanwhile, the largest nurses' union says its members report that most hospitals are not ready for an Ebola patient.

Accountable Care Organizations participating in the Medicare Shared Savings Program will have access to a new initiative that will support care coordination across the country, according to CMS. Up to $114 million in upfront investments will be made available.

If Congress had not pushed back the deadline for implementing ICD-10 last spring, the United States now would have a specific code for tracking Ebola, according to an infographic from the Coalition for ICD-10.

Quality in Medicare Advantage plans is increasing, and CMS credits the improvement to its star rating system. A growing number of Medicare enrollees are in plans receiving at least 4 out of 5 stars, according to a new fact sheet.

The quality bonus payments tied to CMS' star ratings makes it critical that health plans receive a 4 or better, Jonathan Harding, MD, chief medical officer of the Senior Products Division at Tufts Health Plan, said at the America's Health Insurance Plan's National Conferences on Medicare and Medicaid, and Dual Eligibles Summit in Washington, DC, from September 28 to October 2.

In states that chose not to expand Medicaid eligibility under the Affordable Care Act, residents with a median income of less than $800 a month are now ineligible for coverage assistance while those with more than $2000 a month are eligible for subsidies, according to a report from the Urban Institute.

Blue Cross and Blue Shield of Illinois announces the first specialty intensive medical home program in the state, with the Illinois Gastroenterology Group, the state's largest independent gastroenterology practice, effective September 1, 2014.

Fewer than 15% of physicians routinely recommend HPV vaccination to male patients, according to the study published in the journal Cancer Epidemiology, Biomarkers & Prevention.

Although many providers are looking to implement cloud, big data, social, and mobile technologies within the next 2 years, if they haven't done so already, few healthcare organizations feel their infrastructures are prepared for this evolution of electronic medical records, according to a new study.

A survey by Kaiser Family Foundation projects 13.2% overall growth in Medicaid through fiscal year 2015, but the difference between states that expanded the program and those that did not will be stark. The survey of state Medicaid directors also finds 23 states plan expansion of managed care in the next year.

Those planning to purchase health insurance on the Obamacare exchange will soon find out how much rates have increased-after the November 4 election.

With the enormous amount of data being collected and entered into EHRs, the human brain (in this case the physician brain) is probably tuning out information that would probably stay if there was a conversation with the patient instead.

The American Society of Clinical Oncology has endorsed the joint guidelines established by the 3 Associations to help physicians make evidence-based decisions when selecting patients to administer some of the targeted therapies developed for lung cancer.

Ohio is the latest state to experience a rough transition to managed care in its Medicaid program, according to weekend reports. Delayed payments and service disruptions to fragile patients are among the complaints. Kentucky had a similar bumpy start when it changed to Medicaid managed care in 2011, and Kansas has had many problems recently.

Gilead Sciences' Harvoni represents the first once-a-day, complete treatment pill approved by the FDA to treat the hepatitis C virus (HCV). And for some patients, the drug will be less expensive than Gilead's other HCV treatment, Sovaldi.

Opdivo (nivolumab), which was approved in Japan in July 2014, is being globally developed for evaluation in non-small cell lung cancer (NSCLC), melanoma, renal cell carcinoma (RCC), head and neck cancer, glioblastoma, as well as NHL.

The NDA submitted by Pfizer requests approval of palbociclib as a first-line therapy in combination with letrozole for ER+, HER2- advanced breast cancer.

Reference pricing programs can steer patients to lower-price, adequate quality providers, but potential savings to health plans and purchasers are actually modest, according to a study from the National Institute for Health Care Reform.

Medicaid expansion under the Affordable Care Act has been an overall success for insurers in most states that have implemented it; however, the story is different in Kansas, which switched its entire Medicaid program to a private model.