Category: FierceMarkets

Kentucky lawsuit won’t decide the fate of Medicaid work requirements in other states

Michigan’s recent decision to expand Medicaid work requirements likely won’t hinge on the outcome of the Kentucky waiver lawsuit, one healthcare attorney tells FierceHealthcare. A judge is expected to issue a decision on the Kentucky lawsuit this week.

AHA ‘strongly opposes’ interoperability as a Medicare requirement

Responding to a request for information from CMS, the American Hospital Association said it “strongly opposes” revising Medicare Conditions of Participation to include interoperability requirements. The hospital association argued that interoperability…

Humana lawsuit over denied payments, the first of its kind, moves forward

A federal judge has ruled that Prime Healthcare’s lawsuit against Humana over denied or underpaid MA reimbursement can move forward, in what an attorney says is a first-of-its-kind ruling.

AHIP18: Medicaid overhaul is happening, but it’s not coming from Congress

While there are whispers that congressional Republicans might try to overhaul the Medicaid program, some AHIP18 speakers believe innovation at the state level represents the real overhaul.

Blues administrative spending surged 5.9% in 2017, the highest in years

Spending by 14 Blue Cross and Blue Shield insurers on administrative activities increased by almost 6% last year, the highest since 2013. The findings follow another study that found some Blues saved billions under the GOP tax law.

House passes sweeping opioid measure

The measures are expected to be bundled and sent to the Senate for consideration.

AHIP18: How Intermountain plans to fight pharmaceutical monopolies as a generic drugmaker

After watching Martin Shkreli raise the price of a drug by more than 550% in 2015, Intermountain’s Dan Liljenquist had the same thought as the rest of America: Is this really happening? So the system decided to create a nonprofit generic drug company that Liljenquist calls a “first-of-its-kind societal asset.”

AHIP18: Atul Gawande echoes no ‘instant solutions’ from Amazon-Berkshire-JPMorgan venture

The new CEO of the Amazon-Berkshire-JPMorgan healthcare venture offered no specifics on his goals for the organization but acknowledged his presentation at AHIP about healthcare’s inefficiencies would “take on some greater significance.” He also temper…

Work requirements, consolidated health programs part of White House reorganization proposal

Under the proposed plan, the Department of Health and Human Services would be renamed the Department of Health and Public Welfare and would establish work requirements for individuals receiving public assistance from any federal agency.

AHIP18: Coming soon to an MA plan near you—housing, vegetables, church visits

Medicare Advantage plans could soon pay for healthy food, home repairs and transportation to church services if one palliative care specialist gets her way.