Category: Healthcare Finance News

Humana sued over alleged Medicare Advantage 340B overpayments

Montgomery, Alabama-based Baptist Health is suing major insurer Humana over alleged Medicare Advantage underpayments for outpatient drugs purchased through the 340B program.
The hospital claims that reimbursements for the drugs were determined by a pay…

Ambience secures $70 million in funding from Optum, OpenAI Startup Fund

Artificial intelligence technology specialist Ambience Healthcare, which specializes in AI-powered applications and an operating system to improve system efficiency for organizations, announced a $70 million funding round. 
The Series B round was led b…

CDC cautiously eyeing new COVID-19 variant

The Centers for Disease Control and Prevention is now monitoring a new COVID-19, BA.2.87.1, which has more than 30 changes in the coronavirus spike protein and has been detected nine times in the Republic of South Africa.

HHS rule to support Tribal child support programs

The U.S.

FTC scores $195M judgment against Simple Health over allegedly bogus insurance

The Federal Trade Commission has obtained a $195 million judgment against Simple Health Plans and its CEO, Steven J. Dorfman, over charges they duped consumers into signing up for “sham” healthcare plans that did not deliver the promised coverage or be…

Medicare beneficiaries to receive Part D out-of-pocket cap

Beneficiaries with Medicare Part D are poised to reap significant savings with the implementation of a $2,000 out-of-pocket spending cap for prescription drugs covered under the program, which is slated to take effect in 2025.
This provision, signed in…

Administration to set sights on homelessness as a health issue

The U.S.

HHS seeks to enhance care for substance use disorder

The U.S. Department of Health and Human Services, through its Office for Civil Rights and the Substance Abuse and Mental Health Services Administration (SAMHSA), has finalized modifications to the Confidentiality of Substance Use Disorder Patient Recor…

Amazon’s One Medical is closing corporate offices

Amazon-owned One Medical has confirmed that it is closing several of its offices in a move intended to cut costs, with offices in New York, New York, Minneapolis, Minnesota and St. Petersburg, Florida set to shutter their doors by the end of February.

CMS proposed rule strengthens oversight of Accrediting Organizations 

The Centers for Medicare and Medicaid Services has released a Notice of Proposed Rulemaking to bolster oversight of Accrediting Organizations in the Medicare and Medicaid program.
In recent years, CMS has identified several concerns related to Accredit…