The Latest

• 

  FTC orders GoodRx to stop sharing users’ health data with advertisers, issues $1.5M fine

  Officials said they’re putting the market on watch with the enforcement against the company, which allegedly collected and shared user data without consent. GoodRx denied all wrongdoing, and said it agreed to the fine to avoid litigation.

  Updated Feb. 1, 2023

  Government

• 

  Texas Medical Association files fourth suit challenging surprise billing ban

  The latest lawsuit focuses on boosted fees that both parties must pay for arbitration to solve billing disputes between providers and payers.

  Hospitals

• 

  Humana expects 14% hike in 2023 MA enrollment as it taps new leaders

  The payer said it expects to pick up 625,000 individual Medicare Advantage members in 2023.

  Payer

• 

  CMS to crack down on Medicare Advantage audits, poised to claw back billions of dollars from insurers

  Federal regulators have raised concerns about alleged payment abuses in the MA program for years, specifically for those tied to risk adjustments. 

  Payer

• 

  Ascension names new president

  Eduardo Conrado will assume the role from Joseph Impicciche, Ascension’s current chief executive officer.

  Hospitals

• 

  Consolidated systems charge more for ‘marginally’ better care, study finds

  Care delivered by physicians in health systems costs between 12% and 26% higher than care delivered by independent physicians, according to a study published in JAMA Network.

  Hospitals

• 

  Insurance lobby blasts Medicare Advantage audit rule

  The America’s Health Insurance Plans lobby said the rule seeking to claw back billions of dollars from health insurers is unlawful and fatally flawed. 

  Payer

• 

  COVID-19 public health emergency slated to end in May

  The Biden administration warned that hospitals are at risk of revenue losses and care delays if the public health emergency ends abruptly.

  Government

• 

  Court rules for drugmakers over HHS in 340B fight over contract pharmacies

  The decision is a win for drug manufacturers Sanofi, Novo Nordisk and AstraZeneca. The companies sued the HHS after regulators ordered them to stop restricting sales of 340B drugs to contract pharmacies.

  Hospitals

• 

  Persistent, heightened labor expenses pummeled hospitals last year, Kaufman Hall reports

  Negative margins and heightened labor expenses continued for hospitals in 2022, causing them to suffer their worst financial year since the pandemic began, according to the report.

  Hospitals

• 

  Biden admin moves to undo moral opt-out to ACA contraceptive mandate

  The rule also would create an option allowing people enrolled in health coverage or plans provided by “objecting entities” to obtain contraceptive coverage.

  Updated Jan. 30, 2023

  Payer

• 

  Healthcare labor trends in 2023: increased burnout, executive stress

  A rise in union activity could also persist as the sector continues recovering from the COVID-19 pandemic.

  Hospitals

• 

  Cigna sues CVS, former pharmacy head Bricker over exec’s departure

  In a lawsuit filed Thursday, Cigna alleged that Amy Bricker’s appointment to chief product officer of CVS’s consumer segment places the payer’s trade secrets at risk and violates her noncompete agreement.

  Payer

• 

  Louisiana sends cease-and-desist order to Express Scripts over delayed insurance claims

  State officials began investigating Express Scripts in April after receiving multiple complaints from an independent pharmacy association over the Cigna-owned PBM’s handling of claims.

  Updated Jan. 31, 2023

  Payer

• 

  Minnesota attorney general asks Sanford-Fairview to delay merger

  “It’s more important to do this right than to do it fast,” Minnesota’s Chief Deputy Attorney General John Keller said regarding the deal. 

  Hospitals

• 

  HCA shares slide after company forecasts drop in 2023 profit

  The operator cited widespread inflation and continued effects from the COVID-19 pandemic as potential drags on its guidance this year.

  Hospitals

• 

  More hospitals are electronically sharing health information

  However, discrepancies among providers hint at ongoing challenges, ONC researchers said.

  Hospitals

• 

  FBI takes down hacker group that targeted hospitals

  The notorious ransomware group, known as the Hive, has impacted some of the nation’s most critical industries. 

  Hospitals

• 

  Will Elevance’s Louisiana acquisition kick off BCBS consolidation wave?

  The proposed purchase reminds some industry experts of a period beginning in the 1990s, when nonprofit BCBS plans were acquired by for-profit groups.

  Payer

• 

  Employers ‘disappointed’ in health plan performance, study finds

  Health plans earned a lower average rating in the Leapfrog Group’s latest rankings than in previous years.

  Payer

• 

  Artificial intelligence could save healthcare industry $360B a year

  Broader adoption of AI in healthcare is likely in the near future, and could come with a slew of benefits beyond financial gains, according to McKinsey and Harvard researchers.

  Health IT

• 

  Upcoming Medicaid redeterminations could hamper hospitals, payers

  Medicaid eligibility checks beginning in April will likely curb hospital revenue and enrollment growth for payers, Moody's Investors Service said in a report.

  Hospitals

• 

  Elevance reports $6B profit in 2022 on higher medical membership

  The results come days after the insurer said it plans to buy Blue Cross and Blue Shield of Louisiana, a deal that would expand its reach to 15 states. 

  Payer

• 

  Amazon doubles down on generic drugs with new RxPass subscription

  RxPass will cost Prime customers $5 per month to fill prescriptions from a list of about 50 generic medications.

  Health IT

• 

  Record-breaking 16.3M people signed up for ACA coverage

  The 2023 enrollment numbers reflect a broader policy push from the Biden administration to increase insurance coverage, especially during the pandemic.

  Payer

More stories