Category: Healthcare Finance News

Healthcare staffing exec charged with fraudulently fixing nurse wages

A federal grand jury in Las Vegas returned an indictment last week charging a healthcare staffing executive with conspiring to fix the wages of Las Vegas nurses – and then fraudulently concealing that conspiracy, and the government’s investigation so t…

Select Health, Mark Cuban team to lower prescription drug costs

Salt Lake City-based Select Health and its pharmacy benefits manager Scripius will be one of the first health plans in the U.S. to provide member access to Mark Cuban Cost Plus Drug Company, meaning members will have direct access to the prescription d…

Commercial payers trail Medicare in the coverage of digital medicine

The lack of commercial coverage for digitally enabled care is a roadblock to affordable access to these medical services, according to the American Medical Association.
The model of integrating digitally enabled care with in-person care is not yet real…

Deceptive Medicare marketing draws ire of low-income seniors

Almost everyone 65 and older has received marketing related to Medicare, but some have reported experiences with Medicare marketing that violate federal rules, including marketers asking for Social Security or Medicare numbers outside the enrollment pr…

Two health plans earn 5 stars in NCQA’s annual assessment

Two commercial health plans achieved a 5-star rating – doubling the amount from 2022 – according to the new 2023 H

FDA solicits public comments on phenylephrine-based decongestants

The U.S. Food and Drug Administration held a Non-prescription Drug Advisory Committee meeting last week to discuss the effectiveness of oral phenylephrine as an active ingredient in over-the-counter cough and cold products that are indicated for the te…

PBMs are driving up drug prices through fees, PhRMA report claims

Ahead of a hearing on pharmacy benefit managers before the House Committee on Oversight and Accountability on Tuesday, PhRMA released Nephron Research that contends PBMs are driving up profits and drug prices through

FTC targeting improper drug patents, receives backing from FDA

The Federal Trade Commission has issued a policy statement warning pharmaceutical companies that make and sell brand-name drugs that they could face legal action if they improperly list patents in the FDA’s catalog of “Approved Drug Products with Thera…

HIMSSCast: Don Rucker’s fresh takes on the progress of FHIR, TEFCA and more

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Costs for common healthcare procedures higher in hospital outpatient departments

When common medical procedures are performed in a hospital outpatient department (HOPD) rather than a doctor’s office, costs are substantially higher, according to a national analysis of tens of millions of claims.