Category: Health Insurance

9 States Poised To End Coverage for Millions if Trump Cuts Medicaid Funding

About 3.7 million people are at immediate risk of losing health coverage should the federal government cut funding for Medicaid expansions, as some allies of President-elect Donald Trump have proposed. Coverage could be at risk in the 40 states that have expanded Medicaid.

Lawmakers push DOJ to investigate PBMs over opioids

A bipartisan group of lawmakers has sent a letter to Attorney General Merrick Garland saying that the Department of Justice should examine whether pharmacy benefit managers had a hand in the opioid epidemic.

MultiCare Health System pilots new AI tool for revenue cycle

MultiCare Health System in Washington State is the first health system to pilot a new generative AI tool to streamline appeals in the mid-revenue cycle, according to AI technology company Xsolis.
The technology is used to create and submit appeal lette…

CHS subsidiary buys urgent care centers in Arizona

Community Health Systems subsidiary Northwest Urgent Care has completed the acquisition of urgent care centers owned and operated by Carbon Health in Arizona.
The Tucson, Arizona CHS subsidiary is part of Northwest Healthcare’s integrated network servi…

Health systems see margin gains, though expenses still high

Health systems in the U.S. saw slight margin gains in October following three months of declines, while operating margins for individual hospitals narrowed and expenses remained high, according to new data published by Strata Decision Technology.

VillageMD CEO steps down

VillageMD CEO Tim Barry has stepped down and Chief Operating Officer Jim Murray has been appointed to serve as interim CEO.
The move is “effective immediately,” according to VillageMD spokesperson Molly Lynch, according to the Chicago Tribune.
No reaso…

Alabama hospital expanding behavioral health capabilities

North Alabama Shoals Hospital in Muscle Shoals will be expanding on its behavioral health capabilities with an initiative that includes building a new 16-bed adolescent psychiatry unit and adding eight adult psychiatric beds, the hospital announced.

Ex-pharmacy owner sentenced in $11.5 million Medicare fraud case

Former pharmacy owner Aftab Hussain has been sentenced to two to six years in prison for allegedly stealing more than $11.5 million dollars through a Medicaid fraud scheme that targeted low-income HIV patients who needed life-saving medications, accord…

Who Gets Obesity Drugs Covered by Insurance? In North Carolina, It Helps If You’re on Medicaid

GLP-1 agonist medications such as Ozempic accounted for 10% of the North Carolina state employee health plan’s prescription drug spending, so the state is no longer covering them for weight loss alone. Still, it did decide to cover them for Medicaid patients’ weight loss. A look inside the state’s coverage calculus.

CHS and Woodbridge end $120 million deal in Pennsylvania

Community Health Systems has announced there is no longer a deal to sell three hospitals in Pennsylvania to Woodbridge Healthcare.
The divestiture was expected to go through this quarter. Instead, on November 22, the for-profit CHS and nonprofit WoodBr…