December 11, 2024
Michael McAuliff
One of the Senate’s most liberal members has teamed up with one of its most conservative on legislation that would break up healthcare behemoths such as UnitedHealth Group, CVS Health and Cigna.
Sens. Elizabeth Warren (D-Mass.) and Josh Hawley (R-Mo.), joined in the House by Reps. Diana Harshbarger (R-Tenn.) — a pharmacist — and Jake Auchincloss (D-Mass.), unveiled the Patients Before Monopolies Act of 2024, or PBM Act, on Wednesday. The measure would prohibit corporations that own pharmacy benefit managers or health insurers from also owning pharmacies.
This would have a dramatic effect on some of the biggest companies in the healthcare sector.
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.
October 07, 2024
Lauren Berryman
Next year’s Medicare Advantage landscape appears relatively stable on the surface. But beneath that lie notable coverage cutbacks health insurers made to recover margins after a turbulent year.
The large number of Medicare Advantage plans available for 2025 and a lower average premium tell one story. Insurers exiting geographic markets, reducing benefits and imposing higher out-of-pocket costs reveal another. Just over half of nearly 67 million Medicare beneficiaries are on Medicare Advantage and open enrollment begins a week from Tuesday.
September 18, 2024
Katherine Davis
Chicago-based healthcare firm Oak Street Health has agreed to pay $60 million to resolve allegations from the U.S. Department of Justice that it paid kickbacks to third-party insurance agents in exchange for recruiting seniors to Oak Street’s primary care clinics.
The DOJ alleged in a statement today that Oak Street’s Client Awareness Program, designed to grow patient membership, had third-party insurance agents contacting seniors eligible for or enrolled in Medicare Advantage plans, seeking to recruit them to Oak Street locations.
September 04, 2024
Bridget Early
Gabriel Perna
Telehealth industry and mental health groups are scrambling amid fears the Drug Enforcement Administration is poised to place strict limits on remote prescribing of controlled substances such as Adderall and Vicodin.
The legal authority for clinicians to prescribe DEA-regulated medications through platforms such as Talkiatry expires in less than four months, and the law enforcement agency has moved slowly to issue a final rule after the draft version released last year triggered protests from providers and telehealth companies.
August 20, 2024
Caroline Hudson
The Federal Trade Commission does not have authority to enact its ban on noncompete agreements, a federal judge ruled Tuesday.
Judge Ada Brown wrote the FTC’s near-total ban is “unreasonably overbroad without a reasonable explanation,” siding with the U.S. Chamber of Commerce and tax firm Ryan LLC. Many healthcare organizations include noncompete agreements in employment contracts.