STAT

NOVEMBER 22, 2023

The lawsuit builds on the Federal Trade Commission’s complaint filed in September, which argued USAP and Welsh Carson illegally bought up anesthesia practices across Texas as a way to concentrate market power, gain negotiating leverage over health insurance companies, and raise prices.

Health Insurance Companies 294

Health Insurance Companies Hospitals 294

STAT

MARCH 21, 2023

People and organizations that sometimes make it difficult to access medication can include doctors, methadone clinics, health insurance companies, recovery groups, law enforcement agencies, jails, prisons, drug courts, and labor unions. Read the rest…

Health Insurance Companies 245

Health Insurance Companies 245

STAT

OCTOBER 17, 2022

The Department of Justice filed a new lawsuit against Cigna Monday, alleging the health insurance company overcharged the federal government by purposefully inflating how sick its Medicare Advantage members were. Read the rest…

Health Insurance Companies 277

Health Insurance Companies 277

STAT

OCTOBER 2, 2023

Health care providers and health insurance companies are closing the books on their third quarters, and one major question continues to hang over them: How much care is everyone actually getting, now that Covid-19 isn’t scaring so many away from doctors and hospitals?

Hospitals 257

Hospitals Health Insurance Companies 257

STAT

JANUARY 13, 2023

Oscar Health has excelled at one thing in particular since its inception a decade ago: burning cash. The health insurance company did not plan to be profitable immediately. It was staking its future on the new Affordable Care Act marketplaces and had to grow quickly to compete with larger insurance carriers.

Health Insurance Companies 323

Health Insurance Companies 323

STAT

FEBRUARY 5, 2024

Health insurance companies take a while to reach profitability because they need to enroll a lot of people, which then allows them to spread medical costs across a bigger pool. And Devoted isn’t sharing many details about its progress, either.

Health Insurance Companies 265

Health Insurance Companies 265

STAT

APRIL 28, 2023

Bright Health Group started as a health insurance company. Bright is looking to sell off the Medicare Advantage plans it manages in California, the company said Friday. But it will no longer be one.

Health Insurance Companies 227

Health Insurance Companies 227

STAT

SEPTEMBER 7, 2022

A federal judge in Texas has ruled that parts of the Affordable Care Act mandating health insurance companies cover many preventive services and drugs for free are unconstitutional.

Health Insurance Companies 257

Health Insurance Companies 257

STAT

OCTOBER 15, 2023

7, allowing eligible older adults and people with disabilities to sign up for traditional Medicare coverage or Medicare Advantage, the alternative option that is run by health insurance companies. Medicare’s annual enrollment period kicked off Sunday and runs through Dec.

Health Insurance Companies 288

Health Insurance Companies 288

STAT

MARCH 31, 2023

WASHINGTON — The Biden administration backed off some of its plans to rein in billions of dollars from wasteful spending in Medicare Advantage next year, after intense lobbying from health insurance companies.

Health Insurance Companies 243

Health Insurance Companies 243

STAT

JANUARY 30, 2023

The federal government and health insurance companies have been clashing for more than a decade over how Medicare Advantage plans should be audited and how the well-documented overpayments to those plans should be clawed back.

Health Insurance Companies 276

Health Insurance Companies Documentation 276

STAT

JANUARY 12, 2024

The Medicare Payment Advisory Commission, a group that advises Congress on Medicare policy, gathered to discuss its pending March report on the state of Medicare Advantage, the alternative to traditional Medicare that is run by health insurance companies.

Health Insurance Companies 263

Health Insurance Companies 263

STAT

JULY 17, 2023

Two dominant Blue Cross Blue Shield companies in California intentionally underreported premiums of certain health plans so they could avoid paying Affordable Care Act taxes, according to new federal whistleblower complaints.

Health Insurance Companies 245

Health Insurance Companies 245

STAT

NOVEMBER 6, 2023

The federal government is proposing to rein in health insurance companies that entice brokers with lavish bonuses to sell their Medicare Advantage plans by placing a firmer cap on broker compensation.

Health Insurance Companies 255

Health Insurance Companies 255

STAT

MAY 4, 2023

Option Care Health is buying Amedisys in an all-stock merger valued at $3.6 billion, creating a national company that specializes in almost all types of home care that can be provided from cradle to grave.

Health Insurance Companies 214

Health Insurance Companies Hospitals 214

STAT

JUNE 14, 2023

UnitedHealth is one of the country’s largest health insurance companies, and also owns a major chain of ambulatory surgery centers. A vast majority of the care has come from Medicare enrollees who are getting hip and knee replacements and heart procedures in outpatient clinics, he said.

Health Insurance Companies 252

Health Insurance Companies 252

STAT

OCTOBER 2, 2023

After Congress officially outlawed surprise medical bills last year, there’s been endless, litigious debate as to how health insurance companies and providers should settle their differences over how much to pay for out-of-network medical bills.

Health Insurance Companies 276

Health Insurance Companies Hospitals 276

STAT

JANUARY 20, 2023

It’s a complex tangle of drug manufacturers who’ve been resisting generics , health insurance companies trying to keep up impressive profits , plus the wholesalers who distribute medicines to pharmacies and the pharmacies that provide them to patients.

Health Insurance Companies 252

Health Insurance Companies Drug Pricing 252

STAT

AUGUST 10, 2023

AdventHealth, a large religious-affiliated hospital system, has sued MultiPlan, alleging the company has worked with health insurers to create a “cartel” that systematically underpays hospitals and doctors for care that is delivered out of an insurance company’s network.

Health Insurance Companies 216

Health Insurance Companies Hospitals 216

STAT

MARCH 13, 2023

Health insurance companies hire NaviHealth to mine medical data and predict the post-acute care a patient will need. A STAT investigation found Medicare Advantage insurers are routinely using that unregulated technology to deny care, unbeknownst to patients and regardless of whether they need the treatment.

Health Insurance Companies 244

Health Insurance Companies Inpatient Hospitals 244

STAT

JANUARY 3, 2023

The pandemic’s “public health emergency” has been a boon for state Medicaid rolls and the health insurance companies that manage those programs. What will happen to the pandemic Medicaid enrollees?

Hospitals 227

Hospitals Health Insurance Companies 227

STAT

AUGUST 17, 2023

Blue Shield of California, a health insurance company that covers almost 5 million people, is restructuring how it will pay for prescription drugs by dividing the work up among five different vendors — two of which include Amazon and Mark Cuban’s pharmacy company.

Drug Pricing 211

Drug Pricing Health Insurance Companies 211

PhRMA

MAY 8, 2023

This new law will ensure that Indiana patients aren’t paying more for their medicines than their health insurance company or the middlemen known as pharmacy benefit managers (PBMs). This week, Governor Holcomb signed into law Senate Bill 8 recently passed by the Indiana legislature.

Health Insurance Companies 92

Health Insurance Companies Pharmaceutical Companies Pharmaceutical Companies 92

PhRMA

MARCH 2, 2023

These include things like making sure patients aren’t paying more for their medicines than their health insurance company or requiring first-dollar coverage, so insurance companies cover the cost of certain lifesaving medicines from day one of the plan year.

Health Insurance Companies 118

Health Insurance Companies Hospitals Drug Pricing 118

STAT

SEPTEMBER 6, 2022

But health insurance companies — most of which make sizable profits on the MA plans they offer — are defending the private alternative to traditional Medicare. They say MA remains popular among those who pick their plans and provides extra benefits that help keep older adults healthy.

Health Insurance Companies 246

Health Insurance Companies 246

pharmaphorum

JANUARY 27, 2023

According to court documents, SaveOnSP works ‘in partnership’ with PBM Express Scripts and specialty pharmacy group Accredo Health to operate the programme, which is described as “one way a PBM […] maximises its profits (and, in turn, commercial health insurance companies’ profits) at plaintiff and patients’ expense.”

Health Insurance Companies 104

Health Insurance Companies Specialty Pharmacies Documentation 104

STAT

OCTOBER 5, 2022

The federal government wants to create a national directory that houses accurate, up-to-date information for all doctors and providers across the country — an ambitious attempt to rectify the plethora of error-riddled directories that are maintained by health insurance companies.

Health Insurance Companies 190

Health Insurance Companies Hospitals 190

pharmaphorum

JUNE 16, 2022

.” Sidekick is also working with a number of other pharma companies on companion apps for drug therapies, including Pfizer in the area of atopic dermatitis and Bayer in peripheral artery disease. The new Lilly alliance is one of three that Sidekick expects to announce in the coming months.

Health Insurance Companies 87

Health Insurance Companies 87

Integra X Files

MAY 22, 2023

The politics of healthcare favor providers and suppliers over insurers in the battle over PA reform. After all, every congressional district has pharmacies and physicians, while very few are home to health insurance companies. Is PA Reform on the Way?

Insurance Coverage and Processing 94

Insurance Coverage and Processing Health Insurance Companies 94

pharmaphorum

DECEMBER 1, 2020

Make Helsinki Ltd. founded in 2015 brings complementary services spanning Virtual Reality, Customer Experience, Design, Augmented Reality and recruitment for Clinical Trials on top of a full service agency.

Health Insurance Companies 52

Health Insurance Companies 52

pharmaphorum

MAY 5, 2022

The Iceland-based digital health company – which has just raised $55 million in second-round funding – has been working with Bayer on an app/medicine combination for patients with peripheral artery disease since 2019, and in the following year cut a deal with Pfizer to take a similar approach to five inflammatory disease.

Health Insurance Companies 52

Health Insurance Companies 52

pharmaphorum

JUNE 24, 2022

The company has also developed an aligned business solutions model that sees it partner with pharma companies and other organisations to develop customised versions of the app with disease-specific contents as digital therapeutics. ” The post Biogen and Happify partner on digital support for MS patients appeared first on.

Health Insurance Companies 40

Health Insurance Companies 40

pharmaphorum

AUGUST 18, 2020

Cost savings are one – estimated at $60 million within a couple of years and $500 million down the line – and could be fairly easy to achieve in areas like sales as both companies share a portion of the same customers, for example health insurance companies and managed care.

Health Insurance Companies 69

Health Insurance Companies Diabetes Hospitals 69

STAT

DECEMBER 11, 2023

Less than two weeks after reports surfaced saying Cigna and Humana were considering combining into a giant health insurance company , those merger talks are now dead. Investors hated the merger proposal, with some believing it would not have yielded enough profit quickly.

Health Insurance Companies 246

Health Insurance Companies 246

STAT

APRIL 7, 2023

Health insurance companies that participate in Medicare Advantage will retain billions of extra taxpayer dollars next year thanks to the Biden administration’s recent decision to delay some reforms to the program — UnitedHealth Group alone could pull in at least $900 million of added profit just next year, according to one analyst.

Health Insurance Companies 246

Health Insurance Companies 246

Ramblings of a pharmacist

APRIL 23, 2023

It’s also an error to believe that health insurers care about their members’ health. In reality, health insurance companies want their fully-insured members to be exactly as healthy and expensive as their actuaries guess that their members are, maybe a tiny bit sicker every year.

Insurance Coverage and Processing 76

Insurance Coverage and Processing Independent Pharmacies Diabetes Health Insurance Companies 76

RX Note

JUNE 14, 2023

Under the Commercial Model, the health insurance companies can be for-profit enterprises. The system is based on the demand/supply basis with the possibility to freely choose among different insurance programmes. The premiums are based on risk assessments and the insurances can also refuse the request for insurance.

Health Insurance Companies 52

Health Insurance Companies Communication Hospitals 52