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Industry News

Jan 10, 2018
Insurers on Wednesday renewed their fight to claw back billions of dollars in unpaid risk corridor payments, telling a federal appeals panel that the government legally can't default on its obligation when Congress takes away the money stream.

Three judges from the U.S. Court of Appeals for the Federal Circuit homed in on the government's argument that Congress essentially redefined the intent of the Affordable Care Act's risk corridor provision by limiting what funds could go towards the...

Jan 10, 2018
Cerner has appointed Brent Shafer its new CEO and chairman of the board of directors. He'll begin in the roles on February 1.

Shafer comes to Cerner from Philips North America, where he has been CEO since February 2014. Vitor Rocha will succeed him there.

Before ascending to CEO at Philips, Shafer was CEO of Philips Home Healthcare Solutions. Previously, Shafer spent time at GE Medical Systems and Hewlett-Packard.

"He is committed to innovation, with extensive knowledge of...

Jan 10, 2018

The Trump administration is estimating there are now only 700 issuers in the individual and small group markets, which is down from 2,400 in an earlier estimate.

The CMS posted the updated figure in an information collection notice posted Jan. 8. The agency is seeking permission from the White House's OMB to continue an annual data collection from exchange plans about the risk profile of their enrollees.

In an earlier version of the request submitted to the executive branch...

Jan 10, 2018
The J.P. Morgan Healthcare Conference continued in San Francisco on Wednesday. Quest Diagnostics kicked off the morning, with Community Health Systems and Universal Health Services making afternoon presentations. Modern Healthcare reporter Tara Bannow provides daily observations and news.

Quest will see lower Medicare reimbursement for lab tests

Quest Diagnostics told investors that cuts from a new CMS market-based laboratory payment system will significantly decrease its Medicare...

Jan 10, 2018
Humana officially ended its membership in America's Health Insurance Plans just before the start of 2018, a spokesperson confirmed to Modern Healthcare.

However, the carrier "has not actively participated in AHIP since early 2017," the spokesperson said.

Kristine Grow of AHIP said while Humana scaled back its "engagement with our activities" in 2017, the association understands Humana's move was a "business decision" rather than based on policy disagreements.

Insurers trod...

Jan 10, 2018

Dr. Benjamin Chu joined consulting firm Manatt Health as a managing director, the company announced Wednesday.

Chu, who will be based in Manatt's New York office, will help integrated health systems, academic medical centers and health policy leaders navigate the changing healthcare landscape, according to a news release.

Chu was president and CEO of Memorial Hermann Health System for about a year until he resigned in June, when he announced he was seeking a role in shaping...

Jan 10, 2018
President Donald Trump's administration is aiming to curb the number of veteran suicides by improving mental health treatment for the high-risk group.

Trump signed an executive order Tuesday directing the secretaries of defense, homeland security and veterans affairs to develop a plan to provide "seamless" access to mental health and suicide prevention resources for 12 months for members leaving the armed forces.

"We want them to get the highest care and the care that they so richly...

Jan 10, 2018

A federal judge on Tuesday set a goal of doing something about the nation's opioid epidemic this year, while noting the drug crisis is "100% man-made."

Judge Dan Polster urged participants on all sides of lawsuits against drugmakers and distributors to work toward a common goal of reducing overdose deaths. He said the issue has come to courts because "other branches of government have punted" it.

The judge is overseeing more than 180 lawsuits against drug companies brought by...

Jan 10, 2018
Molina Healthcare has lost a contract to manage New Mexico's Medicaid recipients starting in 2019.

The loss is a blow to the company, which is in the midst of an overhaul after ousting former CEO Dr. Mario Molina and his brother, the former CFO, earlier this year.

Long Beach, Calif.-based Molina is the largest Medicaid managed care plan in New Mexico, serving 225,000 people and bringing in $893 million in premium revenue for the first nine months of 2017, or about 6.3% of Molina's...

Jan 10, 2018

Ask Emily

Senior Correspondent Emily Bazar’s answers consumers’ questions about California’s changing medical landscape.

Send questions for Emily to

Susan Inglett’s dental coverage changed just after she got a root canal on one of her top teeth.

It was 2009, and California was in the midst of a budget crisis. To cut costs, Medi-Cal, the state’s health insurance program for low-income residents, eliminated non...