Suzanne York

FEDERAL COURT RULES PLAINTIFFS ADEQUATELY ALLEGED CVS ACTED WITH “DELIBERATE INDIFFERENCE” WHEN IT ADOPTED RX PROGRAM THAT DISCRIMINATES AGAINST PEOPLE LIVING WITH HIV

Los Angeles, CA – Late Friday the United States District Court for the Northern District of California ruled that four HIV-positive “John Doe” plaintiffs adequately alleged CVS acted intentionally under the “deliberate indifference” standard when it implemented a drug program that discriminates against people living with HIV. Download the Order here. The latest ruling comes in a …

FEDERAL COURT RULES PLAINTIFFS ADEQUATELY ALLEGED CVS ACTED WITH “DELIBERATE INDIFFERENCE” WHEN IT ADOPTED RX PROGRAM THAT DISCRIMINATES AGAINST PEOPLE LIVING WITH HIV Read More »

ELEVANCE HEALTH (ANTHEM) POSTS A DOUBLE-DIGIT INCREASE IN FIRST QUARTER 2024 PROFITS, BEATING ANALYSTS’ EXPECTATIONS

Elevance Health, Inc. (formerly known as Anthem) reported strong first quarter 2024 profits of $2.2 billion, a 12.9% increase from the prior year quarter, beating both analysts’ and Elevance’s internal expectations.  First quarter revenues also increased to $42.6 billion compared to $42.2 billion in the prior year quarter. Elevance also reported that BlueCard membership grew …

ELEVANCE HEALTH (ANTHEM) POSTS A DOUBLE-DIGIT INCREASE IN FIRST QUARTER 2024 PROFITS, BEATING ANALYSTS’ EXPECTATIONS Read More »

UNITEDHEALTH GROUP REPORTS STRONG REVENUES FOR THE FIRST QUARTER OF 2024 DESPITE CYBERATTACK

UnitedHealth Group (“United”) reported strong revenues of $99.8 billion for the first quarter of 2024, growing nearly $8 billion from the prior year quarter.  United’s strong revenues beat analysts’ expectations and caused its stock price to soar by more than 5%.   UnitedHealthcare’s revenues were $75.4 billion in the first quarter, an increase of nearly …

UNITEDHEALTH GROUP REPORTS STRONG REVENUES FOR THE FIRST QUARTER OF 2024 DESPITE CYBERATTACK Read More »

BECKER’S HEALTHCARE REPORTS THAT HOSPITALS ARE INCREASINGLY HAVING PROBLEMS WITH MEDICARE ADVANTAGE PLANS

In an article entitled “Hospitals’ Medicare Advantage problem hits an inflection point,” Becker’s Healthcare reports on hospitals’ increasing problems with collecting payments from Medicare Advantage plans, to the extent that many hospitals are planning or considering terminating their Medicare Advantage contracts. Chip Kahn, President and CEO of the Federation of American Hospitals, was quoted in …

BECKER’S HEALTHCARE REPORTS THAT HOSPITALS ARE INCREASINGLY HAVING PROBLEMS WITH MEDICARE ADVANTAGE PLANS Read More »

NYT INVESTIGATION SHOWS HOW HEALTH INSURERS USE MULTIPLAN TO REDUCE PAYMENTS TO MEDICAL PROVIDERS TO IINCREASE THEIR FEES AND PROFITS AT THE EXPENSE OF PATIENTS

In a front-page investigative report headlined “Patients Hit with Big Bills While Insurers Reap Fees,” the New York Times shows how health insurers use MultiPlan to reduce payments to medical providers, which increases the fees employers pay the insurers and MultiPlan, but which frequently results in higher medical bills for patients. Here’s how it works:  …

NYT INVESTIGATION SHOWS HOW HEALTH INSURERS USE MULTIPLAN TO REDUCE PAYMENTS TO MEDICAL PROVIDERS TO IINCREASE THEIR FEES AND PROFITS AT THE EXPENSE OF PATIENTS Read More »

MOUNT SINAI HEALTH SYSTEM AND UNITEDHEALTHCARE REACH AN AGREEMENT TO RESOLVE THEIR DISPUTES

On March 19, 2024, New York-based Mount Sinai Health System and UnitedHealthcare announced that they had resolved their disputes and reached agreement on a four-year contract for Mount Sinai’s hospitals and physicians to be in-network with the health insurer. In a statement, Mount Sinai CEO Brendan Carr stated: We are pleased to have reached an …

MOUNT SINAI HEALTH SYSTEM AND UNITEDHEALTHCARE REACH AN AGREEMENT TO RESOLVE THEIR DISPUTES Read More »

HEALTHCARE PROVIDERS IMPACTED BY CHANGE DATA BREACH

Health care providers nationwide have been impacted with substantial disruptions to the health care services they provide following a February 2024 data breach by Change Healthcare (https://www.changehealthcare.com/), a technology-based subsidiary of United HealthCare. Change serves as an intermediary between health insurance companies, providers and patients, and claims on its website to be “a trusted partner …

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PANEL RECOMMENDS APPROVAL OF FEDERATION OF AMERICAN HOSPITALS’ PROPOSAL THAT HEALTH INSURERS REPORT PRIOR AUTHORIZATION DENIAL RATES

The Federation of American Hospitals (“FAH”) proposal that CMS add a quality measure to its Medicare Advantage star rating system that would require these plans to report their level 1 prior authorization denial rates has been recommended for approval by an expert panel. The “Level 1 Upheld Denial Rate” proposal is intended to add transparency …

PANEL RECOMMENDS APPROVAL OF FEDERATION OF AMERICAN HOSPITALS’ PROPOSAL THAT HEALTH INSURERS REPORT PRIOR AUTHORIZATION DENIAL RATES Read More »

THE CIGNA GROUP REPORTS STRONG PROFITS FOR THE FOURTH QUARTER AND FULL YEAR 2023, BEATING ANALYSTS’ EXPECTATIONS

Beating analysts’ expectations, the Cigna Group reported strong profits of $1 billion and revenues of $51.1 billion for the fourth quarter of 2023. Fourth quarter revenues were up 12% from $45.8 billion in the prior year quarter. Growth was particularly strong at Cigna Healthcare.  Cigna also reported full year 2023 profits of $5.2 billion and …

THE CIGNA GROUP REPORTS STRONG PROFITS FOR THE FOURTH QUARTER AND FULL YEAR 2023, BEATING ANALYSTS’ EXPECTATIONS Read More »

ELEVANCE HEALTH (ANTHEM) POSTS STRONG FOURTH QUARTER REVENUES AND PROFITS, BEATING ANALYSTS’ EXPECTATIONS

Elevance Health, Inc. (formerly known as Anthem) reported strong fourth quarter 2023 profits of $856 million and strong fourth quarter revenues of $2.6 billion in revenue, beating analysts’ expectations. Its revenues were up nearly 7% from the prior year quarter. As a result of these strong earnings, Elevance raised its quarterly dividend by 10.1% to …

ELEVANCE HEALTH (ANTHEM) POSTS STRONG FOURTH QUARTER REVENUES AND PROFITS, BEATING ANALYSTS’ EXPECTATIONS Read More »

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