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Mayo Clinic to close 6 clinics, consolidate service lines
The nonprofit provider said low patient volumes and persistent staffing shortages motivated the decision.
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Sponsored by RAAPID INCThe single source of truth for member risk: Breaking risk adjustment’s speed-accuracy-ROI trilemma
Your members have more conditions than you're capturing. Here's how to find them 5X faster.
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Medicare Advantage penetration doesn’t translate to lower hospital margins: MedPAC
The findings throw cold water on allegations from hospital groups that MA plans contribute to shrinking margins.
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AHA accuses drug companies of colluding to impose 340B rebate plans
The hospital lobby wants the Trump administration to investigate Johnson & Johnson, Eli Lilly, Sanofi, Novartis and Bristol Myers Squibb, citing the suspicious timing of their 340B rebate proposals.
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TrackerThe Trump administration is overhauling healthcare policy. Follow the changes here.
The FDA said it’s sending letters to drugmakers demanding they take down or modify ads that don't comply with federal guidelines, out of concern consumers aren’t seeing a “fair balance” of risks and benefits in drug ads.
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Alamy
FTC drops Biden-era noncompete ban but promises continued enforcement
Industries “plagued by thickets of noncompete agreements” will soon see warning letters from the agency, its chairman said Friday.
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Rebecca Pifer/Healthcare Dive
Judge allows Epic antitrust suit to move forward
A judge dismissed several claims brought by startup Particle Health against the EHR giant, but allowed some federal allegations to continue in court.
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House Republicans probe CVS for alleged HIPAA violation
In June, CVS sent a mass text to pharmacy customers in Louisiana urging them to contact their representatives to oppose a PBM reform bill. That may have been illegal, two Republican congressmen say.
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More than 600 Kaiser workers hold 1-day strike in Northern California
Certified nurse midwives and registered nurse anesthetists walked off the job Monday amid contentious negotiations of their first labor contract.
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States unprepared to implement Medicaid work requirements: report
Implementing work requirements should be a “multi-year project,” researchers said, but states have just until next year to prepare.
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Aetna, Optum settle ‘dummy codes’ case for $8.4M
The decade-long case alleged that Aetna and Optum Health conspired to pass along administrative costs to patients by disguising them as medical codes.
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Courtesy of Medtronic
Renal denervation gets strong backing from cardiologists ahead of Medicare coverage decision
Doctors told the CMS that more patients need access to the procedure, with one calling it the start of a new era in hypertension management.
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HHS expands access to catastrophic plans ahead of premium pain on ACA exchanges
The move will give more Americans a coverage alternative with low monthly premiums come November’s open enrollment, but could come at the expense of people who remain in standard Affordable Care Act plans.
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Elevance cuts MA footprint, exits standalone Medicare prescription drug plans
Roughly 150,000 individual and group MA members will be affected by the plan exits, as will some 400,000 Part D enrollees.
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At Senate hearing, lawmakers express dissatisfaction with RFK Jr.’s vaccine moves
Robert F. Kennedy Jr. faced criticism Thursday even from Republican lawmakers over changes to federal vaccine policy as well as a leadership crisis at the CDC.
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UnitedHealthcare, Humana are gaming Medicare Advantage risk adjustment, analysis finds
The research from the Alliance for Community Health Plans adds to existing evidence that major insurers are unfairly profiting from MA’s risk adjustment system, driving billions of dollars in unnecessary costs.
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Megan Quinn/Healthcare Dive
Lawmakers scrutinize AI’s role in prior authorization, mental healthcare in House hearing
Witnesses said that more oversight is needed to help the industry overcome a “foundational trust deficit” currently blocking uptake of artificial intelligence in healthcare.
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Top healthcare legislation to watch so far this year
Federal lawmakers have proposed dozens of bills targeting core healthcare issues, including 340B, Medicaid, AI and site-neutral payments.
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HHS threatens crackdown on information blocking
The HHS says it will commit new resources to targeting and punishing providers, health IT companies and other groups found information blocking, though the pledge is scarce on details.
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Florida seeks to eliminate vaccine mandates, including for children
State Surgeon General Joseph Ladapo says the state health department can abolish some vaccine requirements while others need lawmakers’ approval.
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CMS tweaks AHEAD all-payer model for states
The model will now run for one additional year and require providers to assume more downside risk.
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Over 1,000 HHS workers call for RFK Jr. to step down
The letter cites turmoil at the CDC, which is reeling from the firing of Director Susan Monarez and the departure of at least four high-level leaders last week.
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DOJ sues ProMedica Health for ‘non-existent, grossly substandard’ care at nursing homes
The government alleges executives at ProMedica pressured four facilities to increase admissions and cut staffing, even while patient care deteriorated.
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Medicare saved record $2.4B from largest accountable care program last year
ACOs are also improving in quality, according to the CMS data. Still, the Medicare Shared Savings Program has struggled with waning provider buy-in.
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Cigna’s Evernorth invests $3.5B in ex-Walgreens specialty pharmacy
The investment in Shields Health Solutions gives Evernorth greater reach into specialty pharmacy services for providers, which Cigna’s COO has called an “important addressable market expansion opportunity.”
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AI devices with no clinical validation tied to more recalls, study finds
Public companies, which accounted for about half of AI-enabled devices on the market, had a higher rate of recalls and a lower rate of clinical evidence, according to a JAMA study.
