April 01, 2024
LAUREN BERRYMAN
NONA TEPPER
Medicare Advantage insurers will get lower payments next year, the Centers for Medicare and Medicaid Services confirmed in a final rule published Monday.
The Medicare Advantage benchmark rate will decline 0.16% in 2025 under the regulation, which is the same amount the agency proposed in January. This marks the second consecutive year CMS reduced the benchmark rate.
April 04, 2024
KARA HARTNETT
Healthcare consolidation is expected to remain strong in the coming months, given likely cuts in interest rates, health systems’ ongoing pursuit of financial stability and expansion opportunities, and the growing influence of private equity in care delivery.
Private equity firms are increasingly acquiring physician practices and healthcare staffing firms, while hospitals are exploring mergers to reduce costs through economies of scale. Additionally, the industry is seeing growing interest in forming joint ventures and affiliations to bolster financial resilience and diversify services.
March 25, 2024
TIM BRODERICK
LAUREN BERRYMAN
The healthcare industry is starting to play catch-up following a cyberattack on UnitedHealth Group’s Change Healthcare subsidiary nearly five weeks ago that forced the company to disconnect its vital everyday systems.
Change Healthcare processes about 50% of medical claims and manages prior authorization requests and reimbursement processes. The unprecedented network outage has forced hospitals, nursing homes, pharmacies and other providers to scramble as they try to mitigate operational and financial challenges.
March 13, 2024
LAUREN BERRYMAN
The federal government has launched an investigation into UnitedHealth Group and its Change Healthcare subsidiary regarding the unprecedented cyberattack inflicted on the technology company that has wreaked havoc throughout the healthcare system.
Melanie Fontes Rainer, director of the Health and Human Services Department’s Office for Civil Rights, announced the probe Wednesday in a letter addressed to colleagues.
The agency is looking into whether protected health data was compromised and if UnitedHealth has complied with breach notification requirements and federal privacy and security rules.
March 05, 2024
LAUREN BERRYMAN
The Centers for Medicare and Medicaid Services has rolled out efforts to help providers navigate the Change Healthcare outage disrupting healthcare operations nationwide, the Health and Human Services Department announced Tuesday.
CMS ordered its claims administrators to assist pharmacies, hospitals and others that need to use alternate means to process transactions while Change Healthcare, part of UnitedHealth Group’s Optum subsidiary, works to get its systems back online following a Feb. 21 cyberattack. The agency also offered assistance to address the financial squeeze some providers are enduring.
February 26, 2024
LAUREN BERRYMAN
Pharmacies and providers still struggling with disarray six days after UnitedHealth Group division Change Healthcare suffered a cyberattack.
The incident, which the company blames on an unnamed foreign government, continues to disrupt operations for Change Healthcare customers and will persist until at least Tuesday, Change Healthcare disclosed Monday. Clients have faced significant obstacles completing basic tasks such as handling prescriptions and claims.
January 30, 2024
MICHAEL MCAULIFF
If anyone were to ask members of Congress if doctors should be contending with Medicare pay cuts after a pandemic and a period of extraordinary inflation, and amid a chronic physician shortage, nearly all would say no.
Yet, that is what happened on Jan. 1, and even powerful lawmakers who would like to ease or reverse that cut can’t promise it will happen, even after recent actions to forestall hospital cuts and to extend expiring healthcare programs such as federally qualified health centers.
November 02, 2023
ALISON BENNETT
Physicians will be hit with a 1. 25% reduction in Medicare reimbursements next year under a final rule the Centers for Medicare and Medicaid Services issued Thursday.
The American Medical Association and other doctor groups sharply criticized the proposed rule CMS published in July, which contained the same pay cut, and have taken their case to Congress that Medicare fees for physicians should not be reduced.
January 18, 2024
ALISON BENNETT
The Centers for Medicare and Medicaid Services is testing a new community-based behavioral health services model that aims to improve access and quality, the Health and Human Services Department announced Thursday.
Under the Innovation in Behavioral Health Model, physical and mental healthcare providers will form interprofessional care teams with community organizations, which will coordinate care for Medicare and Medicaid enrollees with mental illnesses and substance-use disorders.