Partners HealthCare and Harvard Pilgrim Health Care have tabled their merger discussions—for now, at least. Michael Carson, CEO of Harvard Pilgrim, said that the two will continue to explore “opportunities for collaboration.”
Category: FierceHealthPayer
New Jersey physician charged in $20M telehealth scheme involving expensive pain cream prescriptions
A New Jersey doctor has been arrested for fraudulently prescribing $20 million worth of compounded medications through an elaborate telehealth scheme that targeted Tricare beneficiaries. The arrest comes weeks after the CEO of a Florida telehealth comp…
Red or blue, both political parties have work to do on their 2020 healthcare platforms
In our partisan era, we know Republicans and Democrats rarely agree. But there’s also considerable fighting within each party about how to approach healthcare, and that has to change by 2020, NYU’s Shelly Glied and Stanford’s Lanhee Chen said on Friday.
Payer Roundup—Cigna offers up new mental and behavioral health apps; Anthem focused on growth
Cigna is offering its employers new apps that can help consumers improve their mental well-being and reduce their alcohol consumption. Plus, Anthem’s VP of commercial and specialty products anticipates growth across the board.
Atrium Health agrees to settle antitrust lawsuit over contract language
Formerly known as Carolinas HealthCare System, Atrium will resolve more than two years of civil antitrust litigation over contract provisions that blocked health insurers from promoting innovative health benefit plans and cost-effective services to con…
Big 8 health insurers rake in more than $7B in Q3, setting up strong finish to 2018
Most health insurance companies profited handsomely by the end of this past quarter. Aetna, Molina and UnitedHealth performed especially well, albeit for varying reasons.
Want to speed adoption of new evidence-based care guidelines? Try getting insurers and providers to work together
Better collaboration between insurers and healthcare providers could help accelerate the use of evidence-based care, according to a new report from the Alliance of Community Health Plans.
CMS approves value-based drug payments in Michigan’s Medicaid program
The Centers for Medicare & Medicaid Services (CMS) will allow Michigan’s Medicaid program to enter into outcomes-based drug payments with manufacturers. It’s the second state to receive approval from the agency to move forward with such arrangements.
Why HHS wants Medicare Advantage plans to pay for home modifications, transportation for seniors
Health and Human Services Secretary Alex Azar also teased work by CMMI to pay for benefits like food and housing through Medicaid as he addressed a crowd in D.C. on Wednesday.
Experts: Trump administration’s moves will put drug prices center stage in 2020 election
The Trump administration’s plan to peg Part B drug prices to those paid in other countries may not come to fruition in its current form, but it’s meant more to signal to the healthcare industry—and voters—that it’s serious on this issue, experts say. …
