September 21, 2023
ALEX KACIK
The Federal Trade Commission sued U.S. Anesthesia Partners, one of the nation’s largest anesthesia providers, and its private equity owner Welsh, Carson, Anderson & Stowe for allegedly consolidating its practices in Texas to drive up prices for patients.
September 15, 2023
MARI DEVEREAUX
More hospitals will face readmissions penalties in 2024, a departure from the lower rates of reimbursement cuts providers saw last year, according to preliminary data released Thursday.
While the Centers for Medicare and Medicaid Services has resumed use of its pneumonia readmissions measure, which was excluded last year from its Hospital Readmissions Reduction Program, payment adjustments have not returned to pre-pandemic levels.
September 07, 2023
NONA TEPPER
Some health insurance companies are rethinking prior authorization amid a groundswell of complaints from patients and providers and intensifying government scrutiny.
Health insurance companies employ prior authorization rules to constrain costs and to limit unnecessary care, much as insurers place limits on coverage in other ways. Yet big players such as UnitedHealth Group, Cigna and several Blue Cross and Blue Shield companies have announced plans this year to relax their precertification policies. Provider groups have applauded these announcements, albeit cautiously.
