Author's posts
MA prior authorization bill gets bipartisan support ahead of star ratings release
Bill would establish an electronic prior authorization process for MA plans, including standardization for transactions and clinical attachments.
Steward Health Care abandons Norwood Hospital in Massachusetts
Steward Health Care is closing Norwood Hospital and four satellite facilities in Massachusetts and abandoning the properties, according to bankruptcy filing in federal court in Texas on Monday.
The satellite facilities include Norwood Performance Thera…
AHA urges action as Hurricane Helene affects IV supply
American Hospital Association president and CEO Rick Pollack has sent a letter to President Biden urging immediate action to increase the supply of IV solutions for h
Mary Washington Healthcare latest to outsource revenue cycle
Mary Washington Healthcare in Virginia is outsourcing its revenue cycle operations.
The nonprofit health system of 60 facilities announced it has selected Ensemble Health Partners for its revenue cycle management, joining numerous other hospitals that …
Blue Shield of California challenges PBM model to lower cost of Humira biosimilar
The lower price for members is due to a new Pharmacy Care Reimagined model that unbundles the traditional PBM model, company says.
HIMSSCast: Out-of-pocket expenses are a challenge to keeping people well
Prioritizing wellness means taking into account the out-of-pocket cost for patients, according to Alberto “Beto” Casellas, EVP & CEO of Health and Wellness Platform at Synchrony.
HHS releases guidance for second round of drug price negotiations
The Centers for Medicare and Medicaid Services has released final guidance on the process for the second cycle of drug price negotiations.
Humana is challenging lower Medicare Advantage star ratings for 2025
Humana blames higher industry cut points and one contract decreasing to a 3.5-star rating from a 4.5-star rating in 2024.
CMS releases Acute Hospital Care at Home study
The report compares cost, care, patient experience and more to brick-and-mortar care, ahead of the expiration of the waiver.
J&J backs down from its planned 340B rebate model
The drugmaker says it believes the rebate model is legally permissible and needed to improve the integrity of the 340B program.
