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The midterm election is right around the corner, and healthcare costs are a top issue on the ballot, tied with…
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CMS lifted an enrollment freeze for two contracts under eternalHealth, a Boston-based Medicare Advantage insurer, on Oct. 7. The agency imposed the freeze Aug. 27 after determining eternalHealth’s conduct “poses a serious threat to enrollee health and safety.” Earlier that…
Provider Partners Health Plans is laying off 161 employees spanning three states, according to Oct. 7 Worker Adjustment and Retraining Notification, or WARN, notices. Provider Partners reported 79, 39 and 43 layoffs in Texas, Maryland and Illinois, respectively. The Texas…
Molecular residual disease (MRD) testing is moving into the next phase of precision oncology, extending molecular insight past diagnosis and treatment selection into post-treatment monitoring, surveillance and survivorship. For health systems, the question is not whether to add another test.…
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One of Michigan’s largest employers, General Motors, is switching from Blue Cross Blue Shield of Michigan to Aetna for the administration of salaried, non-unionized employees’ health plans, as reported Oct. 8 by the Detroit Free Press and The Detroit News.…
The owner of healthcare software company HealthSplash was sentenced to 19 years in prison for his role in a scheme that prosecutors said fraudulently billed Medicare and other federal healthcare programs more than $1 billion for medically unnecessary equipment. Brett…
Epic is working with Amazon Pharmacy, Mark Cuban Cost Plus Drugs and other pharmacy companies to develop a tool that will allow clinicians and patients to compare prescription drug prices directly within its EHR system. The new feature, called Prescription…
Value-based care promised better outcomes at lower cost. Years of effort and millions in infrastructure later, payer leaders are asking a blunt question: is it delivering? On Oct. 21, join us for a candid discussion built for payer leaders that…
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A top CMS official wants provider suspensions to quadruple in the next six months as the agency puts new exclusion authority to work and tests AI tools to catch fraud, Nextgov/FCW reported Oct. 15. CMS Deputy Administrator Kimberly Brandt discussed…
Centene is expanding Custom Health Option and Individual Care Expense Arrangements, formerly known as individual coverage health reimbursement arrangements, to all of its Ohio and Oklahoma employees in plan year 2027. An Oct. 16 news release said the development builds…
The American Hospital Association has launched a website to help hospitals and health systems prepare for electronic prior authorization requirements that take effect Jan. 1, 2027. Major provisions of CMS’ 2024 Interoperability and Prior Authorization Final Rule begin on that…
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