Category: News

September 07, 2022

LAUREN BERRYMAN

Walmart will provide preventive care services to UnitedHealth Group Medicare Advantage customers under a 10-year deal the companies announced Wednesday. 

UnitedHealth Group subsidiary Optum’s data and analytics tools will guide Walmart Health clinicians to provide value-based care for Medicare beneficiaries, according to the companies. The initiative will begin in January at 15 Walmart Health locations in Florida and Georgia before expanding elsewhere, and the partners project it eventually will serve hundreds of thousands of patients. The companies also will market a co-branded Medicare Advantage plan in Georgia and Walmart Health Virtual Care will be in-network for some UnitedHealthcare commercial members in January.

August 30, 2022

MAYA GOLDMAN 

The surprise billing arbitration process has gotten off to a rocky start. 

Insurers are accusing providers of submitting every possible claim, even when they know some cases are not eligible for mediation. Providers allege insurers are holding up the federal dispute process by delaying submissions of clear and complete information. The recently published final rule on the process from the Health and Human Services, Labor and Treasury departments likely will not resolve all these problems.

August 26, 2022

MARI DEVEREAUX

Health systems strapped for resources worry that reporting on new quality measures and transitioning to interoperability as part of the Centers for Medicare & Medicaid Services’ final rule will be overly burdensome.

As a result, some hospitals want CMS to offer adequate financial and technological support. For larger systems with deeper resources, the rule doesn’t seem to be a big lift.

August 18th, 2022

Maria Nutile was recently selected by her peers for inclusion in the 2023 edition of The Best Lawyers in America® for her work in Health Care Law.

August 12, 2022

KARA HARTNETT 

The Joint Commission has established new accreditation standards to accelerate equity efforts within healthcare organizations.

As of Jan. 1, accreditation programs for primary care clinics, behavioral health centers, critical access facilities and hospitals will include new mandates for their leaders.

August 08, 2022

NONA TEPPER

A new lawsuit alleges Centene took advantage of enrollee churn between Medicaid and health insurance exchange policies to defraud the federal government and dupe consumers.

August 01, 2022

NONA TEPPER 

The Justice Department lawsuit seeking to block UnitedHealth Group’s $13 billion acquisition of data broker Change Healthcare begins in federal court Monday.

July 07, 2022

MAYA GOLDMAN 

The Medicare Shared Savings Program could see big changes soon if the Centers for Medicare and Medicaid Services enacts a set of policies unveiled Thursday.

June 29, 2022

Fred Schulte, Kaiser Health News

Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel Tuesday.

June 21, 2022 

MAYA GOLDMAN 

An employer health plan didn’t violate federal law by limiting outpatient dialysis benefits for policyholders, the Supreme Court ruled Tuesday.