Suzanne York

ANTHEM POSTS STRONG FIRST QUARTER 2022 PROFITS, BEATING ANALYSTS’ EXPECTATIONS

Anthem, Inc. reported strong profits of $2.4 billion for the first quarter of 2022, an increase of 13.2% over the prior year quarter. Anthem’s operating revenues were also sharply up, growing 18% over the prior year quarter to $37.9 billion. Anthem’s adjusted net income was $8.25 per share, beating analysists’ expectations. In addition, Anthem reported […]

ANTHEM POSTS STRONG FIRST QUARTER 2022 PROFITS, BEATING ANALYSTS’ EXPECTATIONS Read More »

DESPITE THE PANDEMIC BLUE CROSS BLUE SHIELD EXECUTIVES PAID MILLIONS IN BONUSES

An investigative report by WRAL in Durham, North Carolina has reported that despite the Pandemic, Blue Cross and Blue Shield of North Carolina (BCBSNC) has reported strong profits and has paid its top executives millions in bonuses. In 2021, BCBSNC, a not-for-profit corporation, reported annual revenue of $10.7 billion and net revenue or profit of

DESPITE THE PANDEMIC BLUE CROSS BLUE SHIELD EXECUTIVES PAID MILLIONS IN BONUSES Read More »

WHATLEY KALLAS LLP INVESTIGATING NOTIFICATION OF DATA BREACH INVOLVING HIGHMARK HEALTH VENDOR

On March 10, 2022, Highmark Health, a health services company affiliated with several Blue Cross Blue Shield companies, issued a statement revealing that a subcontractor of one of its mail vendors, Webb Mason Marketing, was involved in a data breach that may have impacted as many as 67,147 Highmark members. According to the notification letter:

WHATLEY KALLAS LLP INVESTIGATING NOTIFICATION OF DATA BREACH INVOLVING HIGHMARK HEALTH VENDOR Read More »

OIG ISSUES REPORT FINDING THAT SOME MEDICARE ADVANTAGE COMPANIES USED CHART REVIEWS AND HEALTH RISK ASSESSMENTS TO DISPROPORTIONATELY INCREASE RISK ADJUSTMENT PAYMENTS

The Office of the Inspector General of the Department of Health and Human Services has issued a report entitled “Some Medicare Advantage Companies Leveraged Chart Reviews and Health Risk Assessments to Disproportionately Drive Payments.” The OIG undertook the review due to concerns that Medicare Advantage (MA) plans “may leverage both chart reviews and Health Risk

OIG ISSUES REPORT FINDING THAT SOME MEDICARE ADVANTAGE COMPANIES USED CHART REVIEWS AND HEALTH RISK ASSESSMENTS TO DISPROPORTIONATELY INCREASE RISK ADJUSTMENT PAYMENTS Read More »

OIG REPORT RAISES CONCERNS ABOUT MEDICARE’S PAYMENT OF BILLIONS IN RISK ADJUSTMENT PAYMENTS TO MEDICARE ADVANTAGE PLANS

The Department of Health and Humana Services Office of the Inspector General has issued a report estimating that the Medicare program made $2.6 billion in risk adjustment payments to Medicare Advantage organizations (“MAOS”) in 2017 based solely on diagnoses reported in Health Risk Assessments (“HRAs”). The OIG further found that 80% of the estimated payments

OIG REPORT RAISES CONCERNS ABOUT MEDICARE’S PAYMENT OF BILLIONS IN RISK ADJUSTMENT PAYMENTS TO MEDICARE ADVANTAGE PLANS Read More »

Scroll to Top