Author's posts
Anthem partners with Samsung, American Well on telehealth offering
A new partnership between Anthem, American Well and Samsung will make it easier for 74 million members to access virtual consultations on Samsung Galaxy phones.
New Mexico Health Connections to appeal portions of risk adjustment ruling regardless of pending decision
As a New Mexico district judge weighs a request from CMS to reconsider the court’s risk adjustment ruling, the lead attorney for New Mexico Health Connections said the insurer plans to appeal portions of the court’s February ruling.
CMS readies potential fix to risk adjustment payments
The Office of Management and Budget is reviewing an interim final rule from CMS on the “ratification and reissuance of the methodology” for the risk adjustment program, a sign the agency may be preparing to unfreeze the payments.
HHS reviewing reforms to the Anti-Kickback Statute in addition to Stark Law
During a House Subcommittee hearing on Tuesday, HHS Deputy Secretary Eric Hargan said an RFI on changes to the Anti-Kickback Statute is forthcoming, following an RFI on changes to the Stark Law last month. Hargan said reform is necessary to allow provi…
Emergency physicians sue Anthem over ER policy change
ACEP and the Medical Association of Georgia are asking for a court to put an end to Anthem’s new ER policy, which violates federal patient protection laws, according to a court filing.
Emergency physicians sue Anthem over ER policy change
ACEP and the Medical Association of Georgia are asking for a court to put an end to Anthem’s new ER policy, which violates federal patient protection laws, according to a court filing.
CareZone sues Express Scripts for defamation following contract fight
A mounting battle between Express Scripts and online pharmacy CareZone just got a little more heated. Weeks after CareZone accused Express Scripts of anticompetitive practices, the company claims the PBM made defamatory statements that affected the com…
CMS physician payment proposal nudges open the door for telehealth
Telehealth played a leading role in last week’s 1,473-page proposed rule from CMS that included several new virtual care reimbursement methodologies. Jennifer Breuer, a partner with Drinker Biddle, said the proposed rule is a “game-changer” if it’s fin…
Indiana benefits administrator sues Teladoc to recoup $450K in overcharges
Key Benefit Administrators claims Teladoc notified them of the overcharge due to an accounting error but attempted to reconfigure the refund so it wouldn’t negatively affect their financial statements.
Indiana benefits administrator sues Teladoc to recoup $450K in overcharges
Key Benefit Administrators claims Teladoc notified them of the overcharge due to an accounting error but attempted to reconfigure the refund so it wouldn’t negatively affect their financial statements.
