Category: Healthcare Finance News

Express Scripts to offer Humira biosimilars

Express Scripts, the pharmacy benefits management business of the Cigna Group’s Evernorth, will add three additional biosimilars to its National Preferred Formulary that it said will compete with Humira, the world’s top-selling pharmaceutical drug, in …

Significant differences uncovered between MA, FFS enrollees

Medicare Advantage and fee-for-service Medicare enrollees have some significant differences in the year prior to enrollment in Medicare at age 65, including differing demographic and socioeconomic characteristics – traits that should be afforded more a…

Health Connect America fined more than $4.6M for alleged Medicaid fraud

Franklin, Tennessee-based Health Connect America, with locations in Big Stone Gap and Culpeper, Virginia, has agreed to pay more than $4.6 million to resolve allegations that it billed Virginia Medicaid for services not provided, according to the U.S. …

One in four skip wellness appointments, regular checkups

Many Americans appear to be rolling the dice on their health, with a new Aflac survey showing that about one in four regularly skip checkups because they feel healthy in the moment.
The Wellness Matters survey, conducted among 2,001 employed adults in …

NAHC sues Medicare to preserve home health service benefit

The National Association for Home Care and Hospice has filed a lawsuit against the Centers for Medicare and Medicaid Services and the United States Department of Health and Human Services, challenging the validity of a change in Medicare home health pa…

Healthcare job cuts increase 97% from 2022

Healthcare companies and health-centric product manufacturers have seen job cuts in their industry increase 97% since the first six months of 2022, ranking it fourth among all industries in terms of the number of job cuts during the first half of this …

Cash shortages plague hospitals but there’s signs of improvement ahead

Many hospitals are facing a cash shortage brought on by labor costs, inflation and the continued struggle to recover financially from the pandemic.
Literally three times a day, Plante Moran’s Duane Fitch said he hears from healthcare systems that are o…

Hospitals to get $9 billion in proposed remedy to 340B ruling

Hospitals in the 340B program will get $9 billion under a proposed rule to make them whole in a lump sum payment, according to the Centers for Medicare and Medicaid Services.

Ex-Optum Everycare CEO to helm Confluent Health

Dr. Kristi Henderson is leaving her role as CEO of Optum Everycare to take on the role of CEO at Confluent Health, a group of physical and occupational therapy companies.
Henderson has already begun work in her new role. Confluent Health’s Founder and …

Medicare broadens coverage of FDA-approved Alzheimer’s treatment

Broader Medicare coverage is now available for Biogen and Eisai’s Leqembi, the brand name for lecanemab, following the Food and Drug Administration’s  move to grant traditional approval to the drug that treats individuals with Alzheimer’s disease.