December 07, 2021
NONA TEPPER
UnitedHealthcare must pay $62.65 in total damages for shortchanging TeamHealth clinicians, a Las Vegas jury decided Tuesday.
Category: News
Health Care Fraud Self-Disclosure Protocol
November 8, 2021
U.S. Department of Health and Human Services
OIG updates the Health Care Fraud Self-Disclosure Protocol, publishes three reports, and posts one enforcement action.
CMS requires COVID vaccines for healthcare staff by Jan. 4
November 04, 2021
Maya Goldman
The Centers for Medicare & Medicaid Services will require COVID-19 vaccines for all employees at Medicare and Medicaid-participating healthcare facilities by Jan. 4, and the Occupational Safety and Health Administration will require all employees at businesses with 100 or more workers to be vaccinated by the same date or get tested for the virus weekly, the agencies announced Thursday morning.
FDA advisers back Pfizer’s COVID-19 vaccine for young kids
October 26, 2021
Associated Press
A panel of U.S. health advisers on Tuesday endorsed kid-size doses of Pfizer’s COVID-19 vaccine, moving the U.S. closer to beginning vaccinations in children ages 5 to 11.
UnitedHealth to repay providers shortchanged for COVID vaccine administration
October 21, 2021
NONA TEPPER
UnitedHealth Group has committed to reprocessing all of its commercial claims related to COVID-19 vaccine administration, after federal investigators confirmed the nation’s largest insurer paid “millions” of provider bills 40% less than the Medicare rate for inoculating patients.
The ‘Medicare Advantage-in-a-box’ startup that runs on Amazon’s cloud
October 18, 2021
NONA TEPPER
Medicare Advantage is now so big that startups are forming to sell software and services to other startups as a go-to-market strategy.
BCBS sues COVID testing lab again
October 15, 2021
NONA TEPPER
Another Blue Cross and Blue Shield insurer sued GS Labs over its COVID-19 tests on Thursday, alleging the national testing facility forced commercially insured customers to take unnecessary, expensive tests to fleece Premera Blue Cross out of $26 million.
HHS lays out surprise billing resolution process in new rule
September 30, 2021
JESSIE HELLMANN
The Biden administration on Thursday laid out the process that out-of-network providers and plans can use to settle surprise billing disputes.
Twenty Medicare Advantage insurers racked up half of $9.2 billion in undiagnosed payments
September 22, 2021 NONA TEPPER Twenty Medicare Advantage insurers accounted for more than half of the $9.2 billion the federal government paid for care that beneficiaries may not have needed or received in 2016, according to a Wednesday report by federal investigators. Among these 20 companies, one large insurer stood out for the share […]
Blue Cross antitrust legal woes linger as settlement opt-outs seek damages
September 29, 2021 NONA TEPPER More than 30 people who opted out of Blue Cross Blue Shield’s $2.67 billion antitrust settlement sued the health plan’s national association on Monday, alleging the insurers’ monopolistic activities increased healthcare costs while decreasing quality of care. The suit, filed in the U.S. District Court of the Southern District of […]