After a highly profitable 2022, the nation’s health insurers continue to reap strong profits in 2023. The major health insurers have all reported on their second quarter earnings and they all reported strong earnings. Of the nation’s largest health insurers, UnitedHealth Group posted the highest profits for the second quarter 2023 with $5.5 billion in …
HEALTH INSURERS CONTINUE TO REAP STRONG PROFITS IN 2023 Read More »
The Kaiser Family Foundation has reported that the federal government is poised to pay Medicare Advantage plans at least $12.8 billion in quality bonus payments this year, an increase of 30% over 2022. Annual bonus payments to Medicare Advantage plans have increased every year since 2015. According to the report, UnitedHealthcare will receive $3.9 billion, …
Last month after a tragic mass shooting in Dadeville, Alabama, 15 of the gunshot victims were brought by ambulance and private vehicle to Lake Martin Community Hospital in Dadeville for treatment. Last week, Ivy Creek recognized those first responders with a special lunch. Without the outstanding work of Lake Martin Community Hospital and the other …
In a strongly worded letter sent to UnitedHealth Group’s CEO on May 8, 2023, 175 state and specialty medical associations and physicians’ groups have opposed United’s new policy requiring prior authorization for most GI endoscopic procedures, including colonoscopies, and urged United not to implement the policy as scheduled on June 1, 2023. The letter states …
Gold carding programs are programs that eliminate or reduce prior authorization requirements for providers whose requests for prior authorization have consistently been approved and/or who have met other evidence-based criteria. In its recently published proposed rules for Medicare Advantage plans for the 2024 contract year, CMS encouraged Medicare Advantage Plans to implement gold carding programs, …
A new report released by Crowe, LLP found that Medicare Advantage plans are much more likely than other payers to deny payment for inpatient claims. The report, entitled “Who’s picking up the check,” analyzed data from more than 1,700 hospitals. It found that Medicare Advantage plans denied 5.8% of inpatient admissions in 2022 compared to …
UnitedHealth Group (“United”) reported strong profits for the third quarter of 2022, with double-digit growth at both UnitedHealthcare and Optum. United’s strong third quarter profits beat analysts’ expectations and prompted UnitedHealth Group to increase its earnings forecast for the year. United posted profits of $5.3 billion for the third quarter, up from $4.1 billion for …
New York’s Attorney General, Letitia James, has sued CVS Health Corp., alleging that it violated New York’s antitrust laws and abused its market power by illegally requiring safety net hospitals that contract with CVS pharmacies for dispensing 340B outpatient drugs to exclusively use CVS’s subsidiary Wellpartner as their Third Party Administrator (“TPA”) for the 340B …
On June 24, 2022, in Becerra v. Empire Health Foundation, the Supreme Court upheld the Department of Health and Human Services’ interpretation of the Medicare statute governing how disproportionate share adjustments are calculated for hospitals serving low-income patients. The interpretation upheld by the Court generally reduces the payments available to these hospitals. The case involved …