Suzanne York

CVS HEALTH REPORTS STRONG SECOND QUARTER PROFITS, BEATING ANALYSTS’ EXPECTATIONS

CVS Health has reported strong second quarter profits and revenues, beating analysts’ expectations.  CVS reported second quarter profits of $2.95 billion, up from $2.8 billion for the prior year quarter. This brings its profits for the first half of the year to $5.3 billion.  CVS also reported strong revenues of $80.6 billion for the second …

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NY ATTORNEY GENERAL SUES CVS, ALLEGING THAT IT HARMS SAFETY NET HOSPITALS AND PATIENTS BY DIVERTING MILLIONS FROM UNDERSERVED COMMUNITIES TO CVS

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 …

NY ATTORNEY GENERAL SUES CVS, ALLEGING THAT IT HARMS SAFETY NET HOSPITALS AND PATIENTS BY DIVERTING MILLIONS FROM UNDERSERVED COMMUNITIES TO CVS Read More »

HUMANA REPORTS STRONG SECOND QUARTER PROFITS AND INCREASES ITS ANNUAL PROFIT FORECAST DUE TO LOWER MEDICAL COSTS

Humana, Inc. has reported strong second quarter profits of $696 million, bringing its profits for the first half of the year to $1.6 billion, an increase of 14.8% from the first half of 2021.  Humana also reported strong revenues of $23.7 billion for the second quarter, an increase of 14.6% from the second quarter of …

HUMANA REPORTS STRONG SECOND QUARTER PROFITS AND INCREASES ITS ANNUAL PROFIT FORECAST DUE TO LOWER MEDICAL COSTS Read More »

UNITEDHEALTH GROUP REPORTS STRONG PROFITS FOR THE SECOND QUARTER OF 2022, BEATING ANALYSTS’ EXPECTATIONS

UnitedHealth Group reported strong profits for the second quarter of 2022, with double digit growth at both UnitedHealthcare and Optum. UnitedHealth Group’s strong second quarter profits beat analysts’ expectations. UnitedHealth Group posted profits of $5.1 billion for the second quarter, up from $4.3 billion for the second quarter in 2021.  UnitedHealth Group also posted revenues …

UNITEDHEALTH GROUP REPORTS STRONG PROFITS FOR THE SECOND QUARTER OF 2022, BEATING ANALYSTS’ EXPECTATIONS Read More »

AHA URGES CONGRESS TO INCREASE ITS OVERSIGHT OVER MEDICARE ADVANTAGE PLANS

In a strongly worded letter in advance of a Congressional hearing on Medicare Advantage plans, the American Hospital Association urged Congress to increase its oversight over these plans, stating: “strong, decisive, and immediate enforcement action is needed to protect sick and elderly patients, the providers who care for them, and American taxpayers….” In support of …

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THE SUPREME COURT SUPPORTS HHS’S RULES GOVERNING CALCULATION OF DSH ADJUSTMENTS TO HOSPITALS SERVING LOW-INCOME PATIENTS

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 …

THE SUPREME COURT SUPPORTS HHS’S RULES GOVERNING CALCULATION OF DSH ADJUSTMENTS TO HOSPITALS SERVING LOW-INCOME PATIENTS Read More »

AHA URGES THE DOJ TO ESTABLISH A TASK FORCE TO CONDUCT FALSE CLAIMS INVESTIGATIONS INTO HEALTH INSURERS’ DENIALS OF PATIENT CARE

In a very strongly worded letter, the American Hospital Association has urged the Department of Justice to establish a task force to conduct False Claims Act investigations into commercial Medicare Advantage insurers that routinely deny patient access to services and deny payments to health care providers. By law, Medicare Advantage plans are prohibited from imposing …

AHA URGES THE DOJ TO ESTABLISH A TASK FORCE TO CONDUCT FALSE CLAIMS INVESTIGATIONS INTO HEALTH INSURERS’ DENIALS OF PATIENT CARE Read More »

CLASS ACTION LAWSUIT ALLEGES PARTNERSHIP HEALTHPLAN OF CALIFORNIA ALLOWED DATA OF UP TO 850,000 ENROLLEES TO BE SUBJECT TO RANSOMWARE ATTACK

On May 5, 2022, a member of Partnership HealthPlan of California (“PHC”) filed a class action lawsuit in Humboldt County Superior Court challenging PHC’s failure to adequately store and protect sensitive medical information of up to 850,000 enrollees.  Among other things, the Complaint alleges violations of the Information Practices Act of 1977; the Confidentiality of …

CLASS ACTION LAWSUIT ALLEGES PARTNERSHIP HEALTHPLAN OF CALIFORNIA ALLOWED DATA OF UP TO 850,000 ENROLLEES TO BE SUBJECT TO RANSOMWARE ATTACK Read More »

HHS INSPECTOR GENERAL REPORT FINDS THAT MEDICARE ADVANTAGE PLANS DENIED PRE-AUTHORIZATION REQUESTS AND DENIED PAYMENT FOR MEDICALLY NECESSARY CARE

The Department of Health and Human Services Office of the Inspector General (OIG) has issued a report entitled Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care (“the Report”).  The OIG conducted its investigation as a result of its concern that the government’s payment to Medicare …

HHS INSPECTOR GENERAL REPORT FINDS THAT MEDICARE ADVANTAGE PLANS DENIED PRE-AUTHORIZATION REQUESTS AND DENIED PAYMENT FOR MEDICALLY NECESSARY CARE Read More »

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