More than 5,200 Arkansans could lose Medicaid coverage next month due to the state’s new work requirement. Meanwhile, Seema Verma expressed her approval for New Jersey’s State Innovation Waiver with an emoji.
Category: FierceHealthPayer
Report: To halt rising Part D costs, shift liability to drug companies and insurers
While the federal government would still pick up most of the tab, shifting the burden of high-cost patients would reduce out-of-pocket costs for beneficiaries, says the American Action Forum.
Verma calls on insurers to use APIs. Some answer more enthusiastically than others
For the second time this year, CMS Administrator Seema Verma called on insurers to follow the agency’s lead and release claims data in API format. Some insurers are more enthusiastic than others.
Ways and Means Committee targets physician burden with Medicare Red Tape Relief Project
The committee has spent the last year working to understand what “regulatory burden” means to providers. Now, it wants to act to help them.
Ohio cracks down on PBM contracts after audit shows egregious spread pricing in Medicaid
PBMs collected $224.8 million from taxpayers last year through the model, including more than $208 million on generic drugs. The state will no longer permit it, forcing PBMs to restructure their contracts.
KMG sale cost Humana nearly $800M
With the sale of KMG, Humana is no longer involved in the commercial long-term care industry. But the net loss was minimized by a healthy tax break.
Oscar, Centene plan to stock up on IT talent
Oscar’s CTO said the company will double its engineering and product development workforce after a funding round from Alphabet, and Centene plans to fill 300 highly skilled IT positions.
Grassley urges ‘careful analysis’ of healthcare mergers, citing drug supply chain consolidation
Some suspect the Senate Judiciary Committee, which he chairs, will hold hearings about the pending CVS-Aetna and Cigna-Express Scripts deals in the near future.
After weeks of vocal opposition, Carl Icahn halts fight against Cigna-Express Scripts deal
Prominent investor Carl Icahn justified his retreat from opposing the deal by pointing to recommendations from Institutional Shareholder Services and Glass Lewis.
As CMS retools its advanced payment models, providers still grapple with the tech requirements
As providers gear up to participate in CMS’ revamped payment models, one major hurdle stands in the way for many: technology. Despite investments in better electronic health records and other technological upgrades, plenty of the work and data remains …
