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Scott Evans, PharmD, is taking over operations at San Diego-based Sharp HealthCare with a focus on moving quickly from strategy…
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The No Surprises Act and its arbitration system is now under more scrutiny than at any point since the law went into effect in 2022. Providers have filed millions of disputes and are winning about 85% of them, but collecting…
Elevance Health’s Anthem Blue Cross and Blue Shield in New York is ending contracts with more than 200 social adult daycare facilities, according to a Nov. 5 Politico report. Social adult daycares provide supervision, care and socialization for people who…
Recorded at Becker’s 14th Annual CEO + CFO Roundtable earlier this month, this session will share how systems can better connect insight, decisions, and execution across the patient journey. Learn how iQueue is reinventing healthcare operations by drawing on more…
At least 11 health insurers have now sued CMS over their 2027 Medicare Advantage star ratings, claiming the agency used quality measures that were never formally adopted through the rulemaking process. Combined, the plans say the ratings will cost them…
The specialty pharmacy operated by Allentown, Pa.-based Lehigh Valley Health Network, under Philadelphia-based Jefferson Health, filed a lawsuit Nov. 10 against Highmark regarding the ability to dispense drugs. The complaint, filed in a state court, alleged that Highmark is blocking…
CMS has denied Minnesota more than $112 million in Medicaid reimbursements for the quarter that ended Sept. 30, 2025, MPR News reported Nov. 10. Seven things to know: 1. The disallowance stems from a $259 million deferral CMS issued to…
Many AI projects in hospitals never make it past proof of concept. The technology performs in a demo and then stalls before it reaches a care team. Success depends on more than the model’s sophistication. It rests on the foundation…
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Most major payers improved profitability in the third quarter of 2026, while three of the four largest publicly traded for-profit health systems saw operating margins narrow. Becker’s compared Q3 performance across seven major payers — UnitedHealth Group, CVS Health, Cigna…
Eleven U.S. House representatives, all Texas Democrats, are pushing government officials to act on the state’s Medicaid application backlog, according to a Nov. 10 news release. The news release said the Medicaid backlog grew from 1,671 pending applications at the…
The Arkansas Department of Human Services secured a temporary six-month extension of its Medicaid expansion waiver, Arkansas Health and Opportunity for Me, according to a Nov. 5 news release. The waiver was slated to expire at the end of 2026.…
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