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Payer Issues

CMS' surprise-billing rule is 'underserved gift' to payers: AMA | Merck's antiviral pill cuts COVID hospitalizations | Centene settles 2 payment disputes | UnitedHealth keeps Medicare Advantage dominance | Ochsner workers charged for unvaccinated partners

October 1, 2021 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Louisiana health system issues $200 monthly premium to employees with unvaccinated partners Full story 2. Centene settles with Arkansas, Illinois over alleged overpayments Full story 3. UnitedHealthcare maintains…

UnitedHealthcare, Wellstar hit contract impasse | MA premiums to dip in 2022: CMS | Death allegedly linked to cyberattack on Ala. hospital | SDOH missing in nearly 99% of Medicare claims: study | No Surprises Act: 12 things to know

September 30, 2021 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. UnitedHealthcare, Wellstar contract dispute leaves 80,000 at risk of losing in-network coverage Full story 2. Physicians failing to track social determinants of health in Medicare patients, study…

Walmart Health struggles to bill payers | Humana reaches $11M settlement with nurses | WellCare partners with Carolina Panthers | CEO, COO exits prompt concern at Colo. system | Health insurance markets increasingly concentrated: AMA

September 29, 2021 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Walmart Health employees report hurdles with billing payers, patients overpaying  Full story 2. Health insurance market grows increasingly concentrated, report says: 7 things to know  Full story 3. Colorado health system…

Centene exec resigns | Pa. hospital to close | UnitedHealth develops calculator for COVID testing programs | Humana sues Biogen | Intermountain moves into flat-priced imaging | 2 largest nonprofit systems see finances bounce back

September 28, 2021 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Centene executive resigns: 4 things to know  Full story 2. UnitedHealth develops calculator to simulate COVID-19 testing programs  Full story 3. Tower Health to close 1 hospital, sell another Full story…

UnitedHealth teams up with Apple | Why 3 hospital bills went viral this year | Humana, Centene sue Merck over alleged price inflation scheme | 9 hospitals laying off workers | 94% of Californians insured, but many lack access to care

September 24, 2021 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Centene, Humana sue Merck over alleged 'monopolistic scheme' to inflate drug prices  Full story 2. 9 hospitals laying off workers  Full story 3. UnitedHealthcare, Apple offering free at-home fitness subscriptions to…

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Cigna shakes up leadership | Mich. physician convicted in $100M scheme | BCBS of Mass. adds equity measures to payment models | Humana: Ex-CMO fired for inappropriate texts | 30 Ala. hospitals in jeopardy | CMS approves Clover Health's expansion

September 23, 2021 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Cigna announces wave of executive moves  Full story 2. Michigan physician convicted in $100M healthcare fraud case  Full story  3. BCBS of Massachusetts to pay physicians more for closing racial…

Insurers claimed $9.2B in questionable payments: OIG | Ascension's tech arm to cut 330 jobs | 10 states with steepest COVID case surges | Blue Shield of Calif. partners with Venus Williams | Medicare benefit expansion: 13 stats to know

September 22, 2021 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 20 insurers received half of $9.2B in suspicious Medicare payments, feds report  Full story 2. Ascension's tech business to eliminate 330 more jobs  Full story  3. 10 states with largest…

4 NJ hospitals cut contract with UnitedHealthcare | Hospitals bill insurers $317K for complex COVID cases | Top payers ranked by customer satisfaction | Aetna, BCBS, Cigna, Anthem's virtual care strategies: 7 notes | Hospitals to lose $54B this year

September 21, 2021 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. New Jersey hospitals cut contract with UnitedHealthcare  Full story 2. Average charge for complex COVID-19 hospital stay is $317K+  Full story 3. Top payers ranked by customer satisfaction, experience  Full story 4. It's…

Calif. hospital ends Anthem contract amid dispute | 7 systems lose employees over vaccine rules | Texas hospital explains $555K billing error | 10 best, worst states for health insurance coverage | FEMA to cover NY system's $900M COVID tab

September 17, 2021 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. California hospital ends Anthem contract after alleged contract breaches  Full story 2. CMS won't enforce payer interoperability rules  Full story 3. Texas hospital says coding problem caused $555K COVID-19 billing error  Full…

Anthem hit with federal penalty over plan spending | Intermountain, SCL to merge 33 hospitals, insure 1M | CDC launches payer feedback toolkit | Physician settles false claims suit for $6.7M | 1 killed in accident involving MRI at Utah hospital

September 16, 2021 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Anthem hit with federal penalty over plan spending  Full story 2. Intermountain, SCL Health to merge into 33-hospital system  Full story 3. Prove it, hospital asks unvaccinated employees claiming religious…

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