Category: Healthcare Finance News

UnitedHealthcare looks to retroactively deny emergency room claims

The policy is an attempt to curb healthcare costs, but some providers are worried it could lead to lower reimbursement.

Biogen teaming with Cigna, CVS Health to increase access to its Alzheimer’s drug

The company will enter into a value-based contract with Cigna and an initiative with CVS Health based on screening and education.

Over 100 Houston Methodist employees sue health system over vaccine mandate

A group of Houston Methodist nurses threatened to walk off the job over the hospital’s mandate that they get vaccinated against COVID-19 by June 7 or be fired, according to abc13.

Walgreens completes $6.5 billion wholesale pharmacy sale to AmerisourceBergen

Walgreens Boots Alliance has announced it has completed the sale of its Alliance Healthcare wholesale pharmacy business to AmerisourceBergen for $6.5 billion.
The sale includes $6.275 billion in cash and 2 million shares of AmerisourceBergen common sto…

CMS makes $80 million available for navigators in states with a federally-facilitated marketplace

The Centers for Medicare and Medicaid Services has issued the 2021 Navigator Notice of Funding Opportunity, which will make $80 million in grant funding available to Navigators in states with a federally facilitated marketplace for the 2022 plan year. …

Health plan leaders request inclusion of audio-only telehealth visits to MA risk adjustment

The groups said the move is imperative to ensure health costs are captured adequately and premiums remain stable.

A study in collaboration: 24 hospitals, one health record

The ONE initiative in northeastern Ontario ties 24 acute care hospitals to a single and shared electronic health information system. 
ONE — One Person, One Record, One System — uses standardized, evidence-based clinical best practices across two doze…

Judge rules in favor of HHS in health plan lawsuit on Medicare Advantage star rating calculations

The health plans contend they lost their ability to improve their star ratings due to the CMS interim final rule.

Cost-sharing waivers for COVID-19 patients had substantial financial impact

Insurers should be mandated to continue to waive inpatient out-of-pocket costs, report says.

AHIP updates mission in bid to rebrand, commits to mental health and chronic care

Quality care, affordable coverage and collaboration with insurers are among the new tenets of the organization’s mission statement.