Jeff Lagasse

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Up to 18 million people could lose Medicaid coverage after COVID-19 PHE

Upwards of 18 million people could lose Medicaid coverage, and four million people could become uninsured entirely when the COVID-19 public health emergency expires next year, according to a recently published analysis from the Urban Institute.
This co…

Pfizer teams with Clear Creek Bio on new COVID-19 treatment

Pfizer and Clear Creek Bio, a biotech startup based in Cambridge, Massachusetts, have partnered to develop a new COVID-19 treatment they hope will provide greater efficacy as the virus evolves and proves increasingly resistant to current treatments.

Express Scripts adding Humira biosimilars to formulary

Pharmacy benefit manager Express Scripts, part of Cigna’s Evernorth subsidiary, will be adding Humira biosimilars to its formulary in 2023 as preferred products, which will be available to patients with inflammatory conditions.

Centene divests Magellan Rx to Prime Therapeutics for $1.3 billion

Centene has sold off Magellan Rx to Prime Therapeutics for $1.5 billion, a move that will add Magellan’s specialty drug management to Prime’s pharmacy benefit management tools.
The end result, the companies said, will be a “diversified pharmacy solutio…

AHA prods feds to allow addiction treatment prescriptions through telehealth

The American Hospital Association has penned a letter to the Drug Enforcement Administration, asking the agency to extend and provide clarity to pandemic-era rules that allowed providers to prescribe addiction treatment drugs via telehealth.

Medicare Advantage coverage rising for those with retiree health benefits

As Medicare Advantage continues to grow, it’s expected to surpass Original Medicare in enrollment numbers for 2023 as more insurers enter the market, with an increasing number of employer- and union-sponsored retiree health plans offering Medicare-elig…

UnitedHealthcare loses another lawsuit to TeamHealth in billing fight

UnitedHealthcare, the nation’s largest insurer, has lost its latest legal battle against provider group TeamHealth, with a three-judge arbitration panel in Florida ruling late last week that TeamHealth was owed $10.8 million due to underpayments from U…

Top Stories: Audits show overcharges to Medicare Advantage plans; Attorneys general urge Apple to add reproductive data protections

New audits have raised the question: Are the feds being overbilled in their Medicare Advantage payments? I’m Jeff Lagasse with Healthcare Finance News, and we’ll take a closer look at that and other big news in this week’s Top Stories, including state …

Percent of Texas hospitals at serious risk of closure has nearly doubled since 2020

Nearly one out of every 10 Texas hospitals is at serious risk of closure, and nearly half of all Texas hospitals are facing negative operating margins this year, according to a new report released this week from Kaufman Hall.
The culprit: COVID-19.

Optum Labs funds opening of digital health research center at Cornell

Optum Labs, the research and development arm of UnitedHealth Group, and Cornell Tech have created a collaborative research hub at Cornell University in New York, which will focus on precision behavioral health and advancing equity in healthcare.
The mo…