Category: Health Industry

Exclusive: Social Security Chief Vows to Fix ‘Cruel-Hearted’ Overpayment Clawbacks

New Social Security Commissioner Martin O’Malley is promising to change how the agency reclaims billions of dollars it wrongly pays to beneficiaries, saying the existing process is “cruel-hearted and mindless.”

Concerns Grow Over Quality of Care as Investor Groups Buy Not-for-Profit Nursing Homes

For-profit groups own more than 70% of U.S. nursing homes. Industry leaders and researchers wonder whether corporations and investors can succeed where not-for-profit organizations have struggled. Or, will quality of care suffer in the name of making money?

A New $16,000 Postpartum Depression Drug Is Here. How Will Insurers Handle It?

A pill form of an effective drug for postpartum depression hit the market in December, but most insurers do not yet have a policy on when or whether they will pay for it. The hurdles to obtain its predecessor medication have advocates worried.

Biden Team, UnitedHealth Struggle to Restore Paralyzed Billing Systems After Cyberattack

The cyberattack on a unit of UnitedHealth Group’s Optum division is the worst on the health care industry in U.S. history, hospitals say. Providers struggling to get paid for care say the response by the insurer and the Biden administration has been inadequate.

VIP Health System for Top US Officials Risked Jeopardizing Care for Soldiers

The historically troubled White House Medical Unit is just one part of a government health system that gives VIP care to top officials, military officers, military retirees, and families. Pentagon investigators say some were prioritized over rank-and-file soldiers.

Whistleblower Accuses Aledade, Largest US Independent Primary Care Network, of Medicare Fraud

A recently unsealed lawsuit alleges Aledade Inc. developed billing software that boosted revenues by making patients appear sicker than they were.

Statistical Models vs. Front-Line Workers: Who Knows Best How to Spend Opioid Settlement Cash?

A mathematical model designed to direct spending of opioid settlement funds is at the center of a debate over whether to invest in technology to guide long-term decisions or focus on the immediate needs of people in addiction.

California Pushes to Expand the Universe of Abortion Care Providers

A new California law allows trained physician assistants, also called physician associates, to perform first-trimester abortions without the presence of a supervising doctor. The legislation is part of a broader effort by the state to expand access to abortion care, especially in rural areas. Some doctor groups are wary.

California Hospitals, Advocates Seek Stable Funding to Retain Behavioral Health Navigators

California has supported expanded use of medications in the fight against opioid use disorder and overdose deaths. But hospitals and addiction treatment advocates say the state needs to secure ongoing funding if it wants more behavioral health workers to guide patients into long-term treatment.

With Medical Debt Burdening Millions, a Financial Regulator Steps In to Help

The Consumer Financial Protection Bureau, created after the Great Recession of 2007-09, has increasingly started policing the health care system.