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Independent pharmacy in Iowa sues UnitedHealth and CVS
Osterhaus Pharmacy in Iowa has brought a class action complaint against UnitedHealth Group and affiliates Optum and Optum Rx for allegedly violating antitrust law for alleged breach of contract and on four other claims.
FTC and DOJ issue new merger guidelines
The Federal Trade Commission and the Justice Department have jointly issued new 2023 Merger Guidelines, which guide the agencies when reviewing mergers and acquisitions in healthcare and other industries.
The 51-page document contains 11 guidelines.
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Fees set in independent dispute resolution process for providers and payers
In a final rule on fees for disputed claims, Health and Human Services and other departments are finalizing an amount of $115 per party for disputes initiated on or after t
Kroger enters in-store value-based primary care market
The Kroger grocery store chain, which as Kroger Health operates over 2,200 pharmacies across 35 states, is partnering with Better Health Group to offer value-based primary care to seniors enrolled in Medicare.
This marks Kroger’s and The Little Clinic’…
Biden’s executive order on AI gets provider and payer commitment
Twenty-eight provider and payer organizations have made voluntary commitments to move toward the safe, secure and trustworthy purchasing and use of AI technology, as outlined in President Biden’s Executive Order issued in October, according to the Depa…
Dozens of pharma companies raised prices faster than inflation, triggering Medicare rebates
Dozens of pharmaceutical companies will be required to pay rebates to Medicare for price hikes on prescription drugs that went against the mandate of the Inflation Reduction Act, the Biden Administration announced yesterday.
American Organization for Nursing Leadership teams with Laudio to inform workforce decisions
The American Organization for Nursing Leadership has teamed with Laudio for biannual reports providing data, insights and perspectives to inform the future of work in nursing.
Healthcare spending growth less than half of 2020 COVID-19 numbers
In 2022, healthcare spending in the United States increased 4.1% to $4.5 trillion, or $13,493 per person, according to new analysis from the Office of the Actuary at the Centers for Medicare and Medicaid Services.
This was much slower than growth in th…
Claim denials and payer audits are affecting the revenue cycle
Claim denials are increasing, especially in Medicare Advantage, and it’s affecting hospital’s revenue cycles and patient care.
“We definitely are seeing an increase in denials,” said Sherri Liebl, executive director of Revenue Cycle, CentraCare Health,…
AHA decries site neutral payments in Lower Cost More Transparency Act
The U.S. House of Representatives has passed H.R. 5378, the Lower Costs, More Transparency Act, a bill aimed at mandating greater hospital price transparency and which would curb pharmacy benefit manager spread pricing.
The bill passed the House by a v…
