Category: Healthcare Finance News

FTC and DOJ issue new merger guidelines

The Federal Trade Commission and the Justice Department have jointly issued new 2023 Merger Guidelines, which guide the agencies when reviewing mergers and acquisitions in healthcare and other industries. 
The 51-page document contains 11 guidelines. 

COVID-19, RSV, other viruses buckling workforce in Fresno County 

With hospitals operating at between 20-40% capacity, officials in Fresno County, California are warning of severe working conditions and are urging the public to avoid checking into the emergency room for nonemergency issues.

Humana sued for allegedly using AI for Medicare Advantage denials

Humana has become the latest insurer to be sued over allegedly using artificial intelligence to deny care, with a class action lawsuit claiming the company’s nH Predict AI model was used to deny care to Medicare Advantage members.
The lawsuit accuses H…

Medicare beneficiaries lack access to opioid treatments

Medicare beneficiaries aren’t getting the treatments they need for opioid use disorder and many are dying due to fentanyl, with fewer than one in five enrollees receiving medication to treat their disorder, according to a new report from the Department…

Fees set in independent dispute resolution process for providers and payers

In a final rule on fees for disputed claims, Health and Human Services and other departments are finalizing an amount of $115 per party for disputes initiated on or after t

Kroger enters in-store value-based primary care market 

The Kroger grocery store chain, which as Kroger Health operates over 2,200 pharmacies across 35 states, is partnering with Better Health Group to offer value-based primary care to seniors enrolled in Medicare.
This marks Kroger’s and The Little Clinic’…

JN.1 COVID-19 variant comprising 21% of new cases

The Centers for Disease Control and Prevention is closely monitoring JN.1, currently the fastest-growing COVID-19 variant in the U.S., representing about 21% of new cases, according to the agency’s numbers.

Biden’s executive order on AI gets provider and payer commitment

Twenty-eight provider and payer organizations have made voluntary commitments to move toward the safe, secure and trustworthy purchasing and use of AI technology, as outlined in President Biden’s Executive Order issued in October, according to the Depa…

Dozens of pharma companies raised prices faster than inflation, triggering Medicare rebates

Dozens of pharmaceutical companies will be required to pay rebates to Medicare for price hikes on prescription drugs that went against the mandate of the Inflation Reduction Act, the Biden Administration announced yesterday.

American Organization for Nursing Leadership teams with Laudio to inform workforce decisions

The American Organization for Nursing Leadership has teamed with Laudio for biannual reports providing data, insights and perspectives to inform the future of work in nursing.