shari

January 29, 2025

Nona Tepper  

Promising signs for “public option” health plans sold on state health insurance exchanges spell bad news for providers, who say they’re squeezed by low reimbursements.

Colorado and Washington are the only states that have government-sponsored — but privately administered — public options on their marketplaces. Nevada is set to join them soon and other states may follow. Public option enrollment climbed on Connect for Health Colorado and Washington Healthplanfinder during the open enrollment period that ended Jan. 15, the states reported.

January 22, 2025

Nona Tepper  

Healthcare providers say insurance companies are innovating new ways to make it harder to get paid.

Physicians, hospitals and other providers have always complained of low rates, delayed payments and the usual red tape. But rules insurers such as Blue Cross Blue Shield of Michigan, UnitedHealthcare and Elevance Health have recently announced may be a new battleground in the age-old fight between the two camps.

Health insurance companies justify utilization management and claims review as crucial to constraining healthcare spending and ensuring that patients receive appropriate care.

January 15, 2025

Bridget Early   

The Drug Enforcement Administration is proposing a rule in the Biden administration’s final days that would establish a special registration process for remote prescribing of certain drugs.

On Wednesday, the DEA released a proposed rule that would set up a special registration process for remote prescribing of Schedule II-V controlled substances such as Xanax, Vicodin and Adderall. It also released a final rule for its 2023 proposal that sets up a special registration process for remote prescribing of buprenorphine, a medication used to treat opioid use disorder.

January 07, 2025

Lauren Dubinsky  

Stryker plans to acquire Inari Medical in a deal valued at $4.9 billion and designed to strength its position in the peripheral vascular market.

The deal, announced Monday and approved by both companies’ boards, is expected to close by the end of the first quarter. Stryker will purchase Inari’s common stock for $80 per share. 

Inari Medical’s product portfolio includes medical devices that treat pulmonary embolism, deep vein thrombosis, in-stent thrombosis and arteriovenous fistula. Stryker said the products are “highly complementary” to its neurovascular business.

November 19, 2024

Airielle Lowe, Bloomberg

President-elect Donald Trump is nominating celebrity doctor and television personality Mehmet Oz to lead the Centers for Medicare and Medicaid Services.

“America is facing a Healthcare Crisis, and there may be no Physician more qualified and capable than Dr. Oz to Make America Healthy Again,” Trump said in a statement Tuesday. “Dr. Oz will work closely with Robert F. Kennedy Jr. to take on the illness industrial complex, and all the horrible chronic diseases left in its wake.”  The celebrity doctor ran for Senate in Pennsylvania in 2022, and with Trump’s endorsement defeated former Bridgewater Associates chief executive officer Dave McCormick in a fiercely contested Republican primary before losing to Democrat John Fetterman in the general election.

November 07, 2024

Nutile Law has received a First-Tier ranking in Las Vegas in Health Care Law by Best Law Firms® for the 2025 edition. 

The 15th annual Best Law Firm regional rankings showcase 10,528 Tier 1 firms, 8,832 Tier 2 firms and 5,665 Tier 3 firms, all offering a unique mix of practice area and jurisdictional focuses. In this second independently produced edition, Best Law Firms® continues to recognize firms for their standout legal performance and prowess in specific metro regions and practice areas, highlighting their unwavering commitment to legal excellence.  

November 01, 2024

Bridget Early   

The Centers for Medicare and Medicaid Services has gone ahead with a 2.9% cut to Medicare physician reimbursements for 2025, setting up a lobbying fight when Congress gets back to Washington after the elections.

CMS published the Medicare Physician Fee Schedule final rule Friday, which retains the payment reduction the agency proposed in July. The American Medical Association and other physician societies are pleading with Congress to stop the cut from taking effect or blunt its impact— as it did for 2024 and prior years.

October 23, 2024

Lauren Berryman

It’s official: The massive cyberattack against UnitedHealth Group unit Change Healthcare was the biggest healthcare data breach in history.

The ransomware incident in February affected 100 million people, or nearly 30% of the U.S. population, according to the Breach Portal maintained by the Office for Civil Rights at the Health and Human Services Department. That’s consistent with what CEO Andrew Witty told a House subcommittee in May, when he testified that the breach ensnared about one-third of the country.

October 10, 2024

Nona Tepper  
Tim Broderick 

The Centers for Medicare and Medicaid Services sought to make it more challenging for Medicare Advantage insurers to win top quality scores and the payment bonuses that go along with them. It’s working.

On Thursday, CMS released the latest Medicare Advantage star ratings, and the contrast to just a few years ago is stark. In 2022, 74 Medicare Advantage with prescription drug coverage contracts garnered five-out-of-five stars. For the 2025 plan year, only seven did.