Washington's latest health care brawl is over wonky questions about how last year's law banning surprise medical bills will now actually be implemented by the Biden administration.

Why it matters: Billions of dollars are at stake — either for providers or for patients and employers.

Democrats are considering including major health care reforms in a massive legislative package that could be passed without Republican votes, teeing up a grueling fight with the health care industry — and, potentially, each other.

Why it matters: Expanding coverage and lowering drug prices have long been top priorities for Democrats, and this may be their best opportunity to accomplish these goals.

Spectrum Health and Beaumont Health have signed a merger agreement that would combine a health insurance company and 22 hospitals into one tax-exempt system with almost $13 billion in annual revenue.

Why it matters: This deal would form the largest hospital system in Michigan, raising new concerns about what would happen to hospital and physician prices if the merger is ultimately approved.

If anyone's incentivized to drive down hospital costs, it's state employee health plans. But that's often not where they're focused, per a new study by Georgetown's Center on Health Insurance Reforms.

Why it matters: Hospital prices are cited most frequently by state plans as their top cost driver, but they're more likely to target other forms of health care spending when it comes to curbing costs.

Aduhelm, the Alzheimer's treatment controversially approved by the FDA, won't just put Medicare's budget in peril. The $56,000-per-year drug could single-handedly represent one percentage point of all health care spending by next year, according to an analysis from Altarum.

Why it matters: Americans already pay more for health care than any other country. But since Aduhelm is not close to being a cure — and not even proven to halt the progression of Alzheimer's — "the resultant growth in spending will therefore be sustained for the foreseeable future," Altarum researchers wrote.

The amount Medicare spent on drugs that are dispensed at pharmacies increased 26% from 2013 through 2018, members of the Medicare Advisory Payment Commission wrote in their new annual report.

Why it matters: MedPAC members put the spotlight on pharmaceutical companies, attributing "nearly all of the growth ... to higher prices rather than an increase in the number of prescriptions filled by beneficiaries."

Most hospitals aren't fully complying with a new federal rule requiring them to make their prices available, according to a new study in JAMA Internal Medicine.

Why it matters: The goal of the regulation is to allow price shopping and, thus lower costs, although it's unclear whether it'd have this effect.

The CEOs of 178 health care companies collectively made $3.2 billion during the coronavirus pandemic, which was 31% more than 2019, according to an Axios analysis of financial filings.

The big picture: Health care executives took home more than ever because a vast majority of their pay still comes in the form of stock. So while the coronavirus ravaged people's lives, the health care system and the broader economy, the soaring stock market immunized executives' pay.

Last year, drug company Mallinckrodt paid its top five executives nearly $33 million, including $15 million to CEO Mark Trudeau.

Why it matters: Last year, Mallinckrodt filed for bankruptcy, faced numerous opioid lawsuits, and shelled out $640 million in underpaid rebates to the federal government — all problems that have come under the watch of executives receiving these lavish pay packages.

Hospitals sued patients much less often in 2020 than in the previous two years, and there are signs that this may signify change that lasts beyond the pandemic, according to new research by Johns Hopkins University provided exclusively to Axios.

Between the lines: Some hospitals that received a lot of negative publicity over their billing practices stopped suing patients altogether.