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Industry News

Apr 17, 2018

The fight over third-party premium assistance for dialysis patients is heating up this week in California and Congress as employers and labor unions get involved.

The broadening interest in the issue shows the mounting financial stakes for the insurance and dialysis industries. The focus has expanded from dialysis patients in the Obamacare individual market to those in the employer market. The sheer market size of dialysis giants DaVita and Fresenius means commercial insurers often...

Apr 17, 2018

President Donald Trump's pick to be Veterans Affairs secretary is promising not to privatize the agency, a key Democratic senator said Tuesday, taking a stance on a politically charged issue that his predecessor says led to his firing.

The confirmation hearing of Ronny Jackson, Trump's White House doctor and a Navy rear admiral chosen to speed up improvements to the VA, is scheduled for next week. On Tuesday, he met privately with Sen. Jon Tester of Montana, the top Democrat on the...

Apr 17, 2018

A doctor, a patient recruiter and four pharmacists in metro Detroit have been indicted on charges ranging from the unlawful overprescribing of opioids to healthcare fraud.

The state stripped Hamtramck doctor Asm Akter Ahmed of his medical license for allegedly overprescribing commonly abused drugs such as the muscle relaxer called carisoprodol (also sold under the brand name Soma), and promethazine codeine syrup, according to a Monday news release from the Department of Licensing and...

Apr 17, 2018

Highmark Health, a Pittsburgh-based Blues plan, has entered into a value-based drug pricing contract with pharmaceutical company AstraZeneca for the drug Symbicort, which is used to treat asthma and other chronic lung diseases.

Under the contract, Highmark said it will track whether the symptoms of its plan members using Symbicort are in line with the results of AstraZeneca's clinical trials. If the drug doesn't live up to its promise, AstraZeneca will provide Highmark with some...

Apr 17, 2018

U.S. health officials on Tuesday proposed steps to improve the government's system for overseeing medical devices, which has been criticized for years for failing to catch problems with risky implants and medical instruments.

The plan from the Food and Drug Administration includes few immediate changes, but lists a number of ideas and proposals with the goal of improving safeguards on pacemakers, artificial joints, medical scanners and other devices.

Among other measures, the...

Apr 17, 2018
UnitedHealth Group kicked off the first-quarter earnings season on Tuesday, reporting higher revenue and net income in the first quarter driven by greater enrollment in Medicare Advantage.

The Minnetonka, Minn.-based health insurance giant reported revenue of $55.2 billion in the three months ended March 31, up 13.3% over the same period a year ago.

Its insurance arm UnitedHealthcare also grew revenue by 13.3% to $45.5 billion in the first quarter.

UnitedHealthcare's total...

Apr 16, 2018
Henry Ford Health revealed last week that its insurance arm owes $12.7 million to the CEO of one of its subsidiaries as part of a proposed stock purchase.

In its 2017 year-end financial release on April 12, Detroit-based Henry Ford revealed that its insurance arm, Grand Rapids, Mich.-based Health Alliance Plan of Michigan, was involved in a lawsuit with ASR Health Benefits' CEO Todd Stacy over the value of his one-third ownership in the third-party administrator. HAP, which owns a majority...

Apr 16, 2018
One recent morning at 7, Dr. Eric Wei gathered the emergency room staffers at NYC Health and Hospitals/Harlem in a tight circle. Perched on plastic seats and rolling desk chairs, the doctors and nurses had just completed a 12-hour overnight shift. Instead of asking them to evaluate patient care, the public health system's chief quality officer wanted them to confront the grief and trauma that are part of a day's work in a busy urban hospital.

A week earlier, on March 22, the team had fought...

Apr 16, 2018
Arizona has asked the CMS to allow it to end retroactive coverage for Medicaid beneficiaries.

If granted, the waiver request now under review at the CMS, would nix providers' ability to bill for services provided in the three months before a beneficiary applies for Medicaid coverage, assuming the patient was eligible during that time.

Providers in the state had urged the state not to submit the waiver to the CMS because it could put hospitals in a difficult financial situation and...

Apr 16, 2018

The American Medical Association and the American Society of Addiction Medicine on Monday advocated for a new way to reimburse physicians who treat patients for opioid use disorder, hoping it will help meet the increasing demand for medication-assisted therapies.

The new alternative payment model, called Patient-Centered Opioid Addiction Treatment, would give providers an initial,...

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