Category Archive: FierceMarkets

Unsealed whistleblower lawsuit accuses Molina of fraud in Illinois SNF program

A newly unsealed whistleblower lawsuit accuses Molina Health of deceiving state and federal regulators by neglecting to provide mandatory nursing home care, which violated managed care contracts with the state of Illinois.

Payer Roundup—High deductibles force diabetics to delay care; Florida adds CVS, Walgreens to opioid suit

People with diabetes are more likely to delay care if they have a high-deductible health plan, a new study says. Meanwhile, Florida’s AG added CVS and Walgreens to a long list of defendants in its suit over the opioid crisis.

Top Democrat plans DOJ probe over refusal to defend the ACA in court

With a Texas judge set to make a ruling on the most-recent ACA case any day now, Democratic members of Congress are once again probing the Department of Justice’s refusal to defend the law in court. Only now, they have to deal with Acting Attorney Gene…

Report: Visits to primary care doctors decline, but more patients with employer plans are seeing NPs, PAs

Fewer patients with employer-sponsored insurance are visiting their primary care doctors, but more are seeing other advanced practice providers, according to a new study. 

Report: Employers need to ask these questions before they cover genomic tests

There’s a lot of hype around the still-emerging science of genomics. A new guide released by the Northeast Business Group on Health this week offered some guidelines for employers about how to figure out what’s worth covering—and what might not be wort…

Theft and disclosures account for most healthcare data breaches. But hackers took 3 times as many records

Healthcare data breaches due to theft or unauthorized disclosure have been far more common than hacking incidents, according to a new study. But cyber attackers made off with nearly 133 million patient records.

Provider consolidation is causing premium hikes in rural areas, analysis says

A lack of competition among providers, fueled by consolidation, is largely causing the rural-urban disparity. But consolidation shows no signs of slowing down, leaving some wondering if states should take matters into their own hands.

Partners, Harvard Pilgrim put merger talks on ice

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.” 

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.

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