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Payer Issues

Kaiser settles false claims suit | Amazon debuts online pharmacy | COVID-19 surges in 48 states; where spread is fastest, slowest | CMS sees fewer improper payments | Cigna's Evernorth: 5 notes

November 17, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Kaiser pays $6.4M to settle false claims allegations Full story 2. Fitch: 5 long-term financial trends for health insurers Full story 3. COVID-19 surges in 48 states; US hits…

Ohio hospital sues ProMedica over insurance agreement | COVID-19 hospitalizations rise for 18th day | Va. physician convicted on 52 charges in billing scheme | BCBS of Mich. partners with workplace healthcare provider

November 12, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Ohio hospital files antitrust suit against ProMedica Full story 2. Hospitalizations rise for 18th day; developmental disorders tied to 3x higher COVID-19 death risk — 4 updates Full story…

UnitedHealth beats mental health denial lawsuit | NJ physician charged in $25M billing scheme | COVID-19 hospitalizations at all-time high | Aetna gets new lead | ACA at Supreme Court: 6 notes

November 11, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. COVID-19 hospitalizations hit all-time high; CDC takes stronger stance on masks — 6 updates Full story 2. Chicago nurses placed on leave after delivering dead flowers to…

Cigna refused to cover COVID-19 testing, lawsuit alleges | Humana's CEO sells $30M in shares | CMS issues final Medicaid, CHIP rule | 5 things to know about CVS' new CEO

November 10, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Cigna refused to cover COVID-19 testing, lawsuit alleges Full story 2. Meet the 13 members of Biden's COVID-19 task force Full story 3. US sees 6th day with 100K+…

UnitedHealth ordered to redo 67K mental health claims | Ex-Tenn. system CEO indicted for theft | 'COVID' fee showing up on medical bills | 5 recent CMS rules | Q3 results for Anthem, Cigna, Humana, UnitedHealth

November 5, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. UnitedHealth ordered to reprocess 67,000 mental health claims Full story 2. US hits 100K+ daily cases for 1st time; PPE strains felt nationwide — 4 COVID-19 updates Full story 3. Tennessee…

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UnitedHealth illegally underpaid ER physicians: lawsuit | 146 telehealth services covered by Medicare during the pandemic | Ill. hospital tagged for erroneous billing | Physician who helped design Medicare dies

November 4, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. ER physicians accuse UnitedHealth of illegally underpaying claims Full story 2. OIG tags Illinois hospital for erroneous billing Full story 3. 5 things we know about the 2020 presidential…

500+ BCBS of Mich. workers take buyouts | 39 hospitals face max readmission fines | Birx: US entering 'most deadly phase' of pandemic | 17 payer exec moves | Humana nearly doubles Q3 profit

November 3, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 39 hospitals face maximum Medicare readmission penalties Full story 2. 500+ BCBS of Michigan employees take buyouts Full story 3. US entering 'most deadly phase' of pandemic, Birx…

CMS pitches price disclosure, COVID-19 vaccine rules | Blue Cross Calif. fined over coverage delays | 3 insurers that laid off workers this year | Medicaid deals boost Molina's Q3

October 29, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. CMS issues coverage rules for COVID-19 vaccine: 10 things to know Full story 2. CMS releases final price disclosure rule: 5 things to know Full story 3. 3 insurers that…

Aetna settles 3 HIPAA breaches | CMS' Quality Payment Program results: 6 notes | Ballad to postpone elective procedures in Tenn. | Anthem profit tumbles 81% | Rapid COVID-19 tests coming to 1,000 CVS pharmacies

October 28, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Aetna settles HIPAA breaches affecting nearly 18,500 members Full story 2. Ballad Health to postpone elective procedures at some Tennessee hospitals Full story 3. CVS to add rapid COVID-19 testing at…

Medicare, Medicaid to cover COVID-19 vaccine | ProMedica health plan to terminate Ohio hospital's in-network status | Intermountain, Sanford to merge | Centene's profit balloons to $568M

October 27, 2020 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. COVID-19 vaccine to be covered by Medicare, Medicaid Full story 2. Intermountain, Sanford to merge into 70-hospital system Full story 3. Tennessee hospital suspends elective surgeries Full story 4. Amwell's 2020 Physician and…

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