Month: January 2023

CMS finalizes RADV rule, leave MA plans on the hook for billions

CMS finalizes RADV rule, leave MA plans on the hook for billions

January 30, 2023

LAUREN BERRYMAN 

Medicare Advantage carriers will be on the hook for errors made in diagnostic coding reaching back to 2018 under a final rule the Centers for Medicare and Medicaid Services issued Monday.

The Medicare Risk Adjustment Data Validation, or RADV, regulation took five years to complete after its draft version published in 2018 and attracted vehement opposition from the health insurance industry.

FBI infiltrates ransomware gang that targeted hospitals

FBI infiltrates ransomware gang that targeted hospitals

January 26, 2023

Associated Press

WASHINGTON — The FBI and international partners have at least temporarily disrupted the network of a prolific ransomware gang they infiltrated last year, saving victims including hospitals and school districts a potential $130 million in ransom payments, Attorney General Merrick Garland and other U.S. officials announced Thursday.

CommonSpirit Health sued over data breach involving 600,000 patients

CommonSpirit Health sued over data breach involving 600,000 patients

January 04, 2023

CRAIN’S CHICAGO BUSINESS 

Katherine Davis

Chicago-based Catholic hospital chain CommonSpirit Health has been hit with a proposed class-action lawsuit over its month-long data breach at the end of last year that impacted more than 600,000 patients.

The headwinds facing group Medicare Advantage growth

The headwinds facing group Medicare Advantage growth

January 02, 2023

NONA TEPPER 

New York City’s struggle to switch more than a quarter-million retired government workers and their dependents from traditional Medicare to private health insurance could set an alarming precedent for employers and insurers banking on the fast-growing group Medicare Advantage program.