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Payer Issues

Aetna whistle-blower suspended after accusing CVS Caremark of $1B billing scheme | Wis. hospital at risk of losing Medicare contract | Oscar Health quietly built its own claims processor to simplify physician payments | BCBS drops North Carolina hospital from network after fraud allegations

‌ ‌ ‌ ‌ ‌ May 22, 2018 TODAY’S TOP STORIES 1. Aetna whistle-blower put on leave after accusing CVS Caremark of $1B billing scheme Full story 2. End gag clauses that keep patients in dark about drug costs, CMS…

5 things to know about $54B Cigna-Express Scripts merger | 100 great leaders in healthcare | BCBS of Massachusetts blames federal taxes for $97.2M operating loss | UnitedHealthcare denied a dying mother's liver transplant, until she penned a letter to the CEO

5 things to know about $54B Cigna-Express Scripts merger | 100 great leaders in healthcare | BCBS of Massachusetts blames federal taxes for $97.2M operating loss | UnitedHealthcare denied a dying mother’s liver transplant, until she penned a letter to…

Pa. hospital discloses Medicare billing violations | Trump says 'great health plans' to come in few weeks | Hear keynotes from NewYork-Presbyterian and Cleveland Clinic at Becker's Health IT + Revenue Cycle Conference | Texas hospital closes, allegedly owes Cigna and Aetna $43M

Pa. hospital discloses Medicare billing violations | Trump says ‘great health plans’ to come in few weeks | Hear keynotes from NewYork-Presbyterian and Cleveland Clinic at Becker’s Health IT + Revenue Cycle Conference | Texas hospital closes, allegedly owes Cigna…

Texas physician: BCBS' out-of-network ER policy will 'kill people' | UnitedHealthcare's bundled payment program cuts readmissions 22% | New York hospital reportedly pays CEO $660k to 'disappear' | Bon Secours, VCU Health partner for 4 ACA marketplace plans

Texas physician: BCBS’ out-of-network ER policy will ‘kill people’ | UnitedHealthcare’s bundled payment program cuts readmissions 22% | New York hospital reportedly pays CEO $660k to ‘disappear’ | Bon Secours, VCU Health partner for 4 ACA marketplace plans ? ?…

How Aetna, Anthem, Cigna, Humana and UnitedHealth fared in Q1 | Texas hospital to close | Join 210+ hospital and health system speakers at Becker's Health IT + Revenue Cycle conference | Partners explores merger with 1.2M-member health plan

‌ ‌ ‌ ‌ ‌ May 8, 2018 TODAY’S TOP STORIES 1. Partners HealthCare, 1.2M-member health plan considering merger Full story 2. Cigna CEO: Express Scripts deal leaves very little overlap for antitrust argument Full story 3. Texas hospital to…

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Humana's profit down 56%; Cigna's up 53% | Augusta Health CEO: Anthem is trying to strong-arm independent physicians | Hear Peyton Manning and Venus Williams at Becker's Health IT + Revenue Cycle Conference | California hospital to close, lay off 200 employees

‌ ‌ ‌ ‌ ‌ May 3, 2018 TODAY’S TOP STORIES 1. Augusta Health CEO: Anthem is trying to strong-arm independent physicians Full story 2. 100 great hospitals in America | 2018 Full story 3. California hospital to close by…

Anthem profits up 30% despite 1M drop in enrollment | CMS releases 2019 IPPS proposed rule: 10 things to know | BCBS of Texas may bill patients in full for nonemergent use of out-of-network ED | Humana to pay hospitals based on quality improvement

‌ ‌ ‌ ‌ ‌   April 26, 2018 TODAY’S TOP STORIES 1. CMS releases 2019 IPPS proposed rule: 10 things to know Full story 2. DOJ requests information from Cigna, Express Scripts as merger review continues Full story 3.…

Humana, 2 equity firms to acquire hospice operator for $1.4B | Penn State Hershey drops 2,100 neurology patients | Hear Cleveland Clinic CIO Ed Marx and 260+ speakers at Becker's Health IT + Revenue Cycle conference | HCA TriStar, BCBS dispute generates $14M in balance bills

‌ ‌ ‌ ‌ ‌   April 24, 2018 TODAY’S TOP STORIES 1. Humana, 2 equity firms to acquire hospice operator Curo Health for $1.4B: 6 things to know Full story 2. Penn State Hershey drops 2,100 neurology patients Full…

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