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HUMANA AND CIGNA REPORT LOWER THAN EXPECTED MEDIAL COSTS LEADING TO STRONG THIRD QUARTER 2022 PROFITS

Humana, Inc. and Cigna Corporation both reported strong third quarter 2022 profits due to lower than expected payments to medical providers. Humana reported third quarter 2022 profits of $1.2 billion, beating analysts’ expectations. Humana also reported strong third quarter 2022 revenues of $22.8 billion, up by 10.2% from the third quarter of 2021. In announcing …

HUMANA AND CIGNA REPORT LOWER THAN EXPECTED MEDIAL COSTS LEADING TO STRONG THIRD QUARTER 2022 PROFITS Read More »

WHATLEY KALLAS INVESTIGATING MONOPOLY MAINTENANCE AND PRICING FOR ADVANTIX AND ADVANTAGE FLEA MEDICATIONS

Whatley Kallas is investigating practices by Bayer, the manufacturer of Advantix- and Advantage-branded flea medications for pets, that have allowed Bayer to maintain a monopoly position over the market for veterinary topical flea medications. These practices, and Bayer’s resulting monopoly power, have caused consumers to pay at least tens of millions of dollars more for …

WHATLEY KALLAS INVESTIGATING MONOPOLY MAINTENANCE AND PRICING FOR ADVANTIX AND ADVANTAGE FLEA MEDICATIONS Read More »

ELEVANCE HEALTH (ANTHEM) POSTS STRONG THIRD QUARTER 2022 PROFITS, BEATING ANALYSTS’ EXPECTATIONS

Elevance Health (formerly known as Anthem) reported strong profits of $1.6 billion for the third quarter of 2022, an increase of 7.2% over the prior year quarter. Elevance Health’s operating revenues were also sharply up, growing 11.5% over the prior year quarter to $39.9 billion. Both Elevance Health’s third quarter profits and revenues beat analysts’ …

ELEVANCE HEALTH (ANTHEM) POSTS STRONG THIRD QUARTER 2022 PROFITS, BEATING ANALYSTS’ EXPECTATIONS Read More »

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

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 …

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

NYT ARTICLE EXPOSES HOW MEDICARE ADVANTAGE PLANS HAVE EXPLOITED MEDICARE RULES TO INCREASE THEIR PROFITS

In an article headlined “How Insurance Firms Exploited Medicare Advantage for Billions,” the New York Times has exposed how Medicare Advantage plans make their patients appear sicker than they are in order to significantly increase their profits. The Medicare Advantage plans accomplish this by scouring patient medical records for additional diagnoses that they then report …

NYT ARTICLE EXPOSES HOW MEDICARE ADVANTAGE PLANS HAVE EXPLOITED MEDICARE RULES TO INCREASE THEIR PROFITS Read More »

PATRICK SHEEHAN SPEAKS ON TELEHEALTH COVERAGE ISSUES AT THE MASSACHUSETTS BAR ASSOCIATION’S 2022 HEALTH LAW CONFERENCE

On September 30, 2022, the Massachusetts Bar Association held its annual Health Law Conference. During the conference, which focused on the rapidly evolving area of telehealth law, Mr. Sheehan spoke about issues concerning telehealth coverage issues developing in the context of commercial insurance. For more information about the conference, and to find out how to …

PATRICK SHEEHAN SPEAKS ON TELEHEALTH COVERAGE ISSUES AT THE MASSACHUSETTS BAR ASSOCIATION’S 2022 HEALTH LAW CONFERENCE Read More »

FEDERAL COURT ENDS CUTS TO PAYMENTS TO 340B HOSPITALS FOR OUTPATIENT DRUGS FOR 2022

Judge Contreras of the federal District Court for the District of Columbia has vacated the Department of Health and Human Service’s rule cutting Medicare reimbursement to 340B hospitals for outpatient drugs for 2022.  This means that 340B hospitals will be paid at the default Medicare rate of Average Sales Price plus 6% for these drugs …

FEDERAL COURT ENDS CUTS TO PAYMENTS TO 340B HOSPITALS FOR OUTPATIENT DRUGS FOR 2022 Read More »

FINAL NO SURPRISES ACT REGULATIONS IMPROVE TRANSPARENCY AND FAIRNESS IN SETTING OUT-OF-NETWORK PAYMENT RATES TO PROVIDERS

On August 19, 2022, the Departments of Health and Human Services, Labor, and the Treasury (“the Departments”) issued their long-awaited Final Rules (“Final Rules”) under the No Surprises Act (“the Act”).  The Final Rules significantly changed the previously issued Interim Final Rules in ways that should improve the transparency and fairness of the process for …

FINAL NO SURPRISES ACT REGULATIONS IMPROVE TRANSPARENCY AND FAIRNESS IN SETTING OUT-OF-NETWORK PAYMENT RATES TO PROVIDERS Read More »

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