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Aetna sued by Kraft Heinz for allegedly mishandling data
An employee benefits group at Kraft Heinz Co. has filed a lawsuit against insurer Aetna, accusing the company of breaching its fiduciary duties by leveraging its status as a third-party claims administrator to benefit itself financially.
Medicare Advantage quality bonus program failing to meet objectives, report finds
The Medicare Advantage quality bonus program, established by the Affordable Care Act as part of a package of MA reforms, was expected to reduce payments to MA organizations. But according to a new Urban Institute report, the expected cost savings from …
U.S. News revises ‘Best Hospitals’ methodology in wake of backlash
Following backlash, U.S. News and World Report has made a number of changes to its methodology for its upcoming Best Hospitals rankings, which are due for release on August 1.
Officials from U.S. News, including Managing Editor and Chief of Health Anal…
South Dakota expanding Medicaid to 52,000 residents
South Dakota has decided to expand Medicaid under the Affordable Care Act, and according to the Department of Health and Human Services, this will result in new eligibility for health coverage for about 52,000 residents of the state, including many mem…
Payers could see 7% spike in healthcare costs in 2024
Healthcare costs are expected to increase as much as 7% in 2024 due to continued labor shortages, drug price increases and new contracts between payers and providers – representing a larger jump in costs than in either of the previous two years.
BCBS Arizona launches Prosano Health Solutions subsidiary
Blue Cross Blue Shield of Arizona, or AZ Blue, has launched a new provider services-oriented subsidiary called Prosano Health Solutions that it promises will improve healthcare access for those in the state.
In addition to promoting access, AZ Blue sai…
CMS rolls out plan to cover new Alzheimer’s drugs
The Centers for Medicare and Medicaid Services is releasing new details about how people can get drugs that may slow the progression of Alzheimer’s disease covered by Medicare.
If the Food and Drug Administration grants traditional approval, then Medic…
Outlook strong for healthcare services deals, PwC finds
Coming off strong years for healthcare services deals in 2021 and 2022, volumes have remained resilient through May despite multiple headwinds, including higher interest rates, increased antitrust regulatory review concerns, elevated valuations and gen…
North Carolina puts Friday Health plans into receivership
Following on the heels of Georgia, North Carolina Insurance Commissioner Mike Causey said this week that Friday Health Plans of North Carolina has consented to being placed into receivership, due to its reported insolvency and inability to raise additi…
San Francisco city attorney questions legality of U.S. News and World Report hospital rankings
San Francisco City Attorney David Chiu has sent a letter to U.S. News & World Report today seeking information on the company’s hospital rankings, which have come under scrutiny from medical experts for alleged imprecise methodology and bias.
The lette…
