Category: Healthcare Finance News

Aetna, city of New Haven hit with OCR fines after data breach

Aetna office
The fines are the latest effort on OCR’s part to enforce HIPAA regulations around protected health information.

Anthem is paying $594 million to settle Blues antitrust settlement

Non-COVID utilization is back to 95% of baseline and when coupled with the cost of COVID-19 care, overall utilization is above baseline.

CMS finalizes Medicare payment to support dialysis in the home

Certain new and innovative equipment and supplies will qualify for the additional Medicare payment.

CMS approves Georgia waiver to transition to a non-ACA private sector marketplace

Democratic opponents say the "unlawful waiver" will expose consumers to greater financial risk by encouraging the use of junk plans. 

U.S. reports record breaking number of daily COVID-19 cases, but experts say the worst is yet to come

Last Friday, the CDC reported 99,750 new cases, a record high from the day before.

Centers for Medicare and Medicaid Services announces 51 direct contracting entities

Direct contracting is the next CMMI model and is based on Next Generation, Medicare Shared Savings and Medicare Advantage plans.

Medicare Advantage payment changes for 2022 are expected to increase revenue by 2.82%

CMS is seeking feedback on a potential COVID-19 vaccination measure in the Medicare Advantage and Part D star ratings. 

Telehealth claim lines remained significantly higher in August than previous years

FAIR Health attributes the increase in telehealth utilization to the pandemic, which forced non-emergency procedures to come to a halt in March.

Tennessee hospital rates are up most in counties where mask-wearing is optional

As the percentage of patients residing in mask-requirement counties increases, the growth curve flattens.

CMS issues final rule requiring payers to disclose negotiated rates with providers

Starting in 2023, the rule will require health plans to offer an online shopping tool to give out-of-pocket estimates for 500 of the most shoppable services.