The AMA, AHA and the Federation of American Hospitals were among the 28 groups that say CMS’ freeze on risk adjustment payments will cause premium hikes that prevent many people from obtaining coverage and limit access to medical care.
Category: FierceMarkets
Patient, provider groups urge CMS to reinstate risk adjustment payments
The AMA, AHA and the Federation of American Hospitals were among the 28 groups that say CMS’ freeze on risk adjustment payments will cause premium hikes that prevent many people from obtaining coverage and limit access to medical care.
House Democrats say GOP’s ACA repeal efforts could scale back fraud prevention tools
Critical reporting and oversight provisions contained within the ACA would be lost if repeal efforts succeed, argued two Pacific Northwest representatives on the House Ways and Means Oversight Subcommittee.
Continued push to value-based care the key to lower healthcare costs, experts tell legislators
Policymakers looking to lower healthcare costs must continue to push the industry toward value-based models, experts told legislators at a hearing on Tuesday. In addition, healthcare providers with lower amounts of wasteful spending are targeting the s…
CareZone sues Express Scripts for defamation following contract fight
A mounting battle between Express Scripts and online pharmacy CareZone just got a little more heated. Weeks after CareZone accused Express Scripts of anticompetitive practices, the company claims the PBM made defamatory statements that affected the com…
Payer Roundup—Cigna, Express Scripts schedule merger vote; physician groups back risk adjustment payments
Shareholders of Cigna and Express Scripts will vote on the proposed merger in August that the companies say will create “a blueprint for integrated and personalized healthcare.” Meanwhile, six major physician organizations call for a reversal of risk …
Industry groups weigh in on HHS’ drug price blueprint
As the Trump administration takes aim at rising drug costs, organizations from across the healthcare industry are weighing in on proposals from its blueprint to address the issue.
CMS physician payment proposal nudges open the door for telehealth
Telehealth played a leading role in last week’s 1,473-page proposed rule from CMS that included several new virtual care reimbursement methodologies. Jennifer Breuer, a partner with Drinker Biddle, said the proposed rule is a “game-changer” if it’s fin…
Seeking clarity on racial disparities, Democrats ask insurers about maternal health coverage
More than 30 members of Congress signed letters to 15 major health insurers asking if and how their plans are working to reduce racial disparities in maternal mortality.
L.A. Care Health Plan is committing $31M to recruit primary care doctors
Publicly operated L.A. Care Health Plan has a new strategy in addressing a primary care physician shortage in Los Angeles. The insurer will commit $31 million to recruit doctors, putting money toward overcoming the financial hurdles that keep physician…
