The Healthcare News Diaries
The Healthcare News Diaries
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FTC sues key pharmacy profit managers over insulin prices The agency introduced motion against Caremark, Specific Scripts and Optum Rx, arguing their “anticompetitive and unfair” rebating techniques “artificially inflated” the list cost of lifetime-preserving insulin medications.
UnitedHealth sues CMS more than Medicare Advantage star scores A handful of strategies owned through the country's premier MA payer are the latest to check with the court docket to enable elevate their useful good quality scores.
Other topics include things like staffing methods for healthcare facility at home packages and the future of house healthcare.
Transparency will grow to be progressively critical this calendar year, especially for clinical choice assistance applications or algorithms that support with promises appraisals, reported CB Insights’ Lennox-Miller.
Providers say promises denials are increasing: survey Just about three in 4 suppliers surveyed by Experian Overall health reported the number of claims denied by payers shot up amongst 2022 and 2024.
In exchange for cash, Steward promised its hospitals as collateral. Value advised the courtroom the Massachusetts deal undercuts the lenders’ capacity to safe their loan.
The Commonwealth has currently put in get more info an unbelievable amount of cash to even get us up to now and [I’m] not subjecting [the hospitals] to dangers although you will discover true individuals sitting in beds at this time.”
Blue Cross Blue Defend to pay for $two.8B to settle class motion company antitrust circumstance It is the most important antitrust settlement to date during the healthcare field, In accordance with regulation organization Whatley Kallas, which represented the plaintiffs.
The danger calculus might have currently altered for providers, since they experience fines and damages from lawsuits following details breaches, she pointed out.
In Washington, federal regulators may possibly form the stage for that business immediately after antitrust organizations revised merger guidelines past calendar year that may chill dealmaking.
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Businesses are concentrating on approach designs to manage healthcare fees: survey Just about 50 percent of your businesses surveyed reported healthcare prices will exceed budget projections this yr, WTW claimed.
The flagship occasion in the HFMA draws healthcare finance leaders from hospitals, wellbeing methods, companies and payer markets to discuss difficulties inside the sector. The celebration appeals to over 3,000 attendees and enables professionals to communicate with finance leaders and tailor-made academic sessions.
Blue Defend of California is promising an easier, much less expensive pharmacy benefits product. Can it produce? Massive queries hang more than the California wellness insurance provider's bold experiment — having five vendors carry out PBM functions previously executed by just one — that may threaten BSCA's anticipated financial savings.