Patient data has been exposed in a recently announced security breach impacting almost 8.5 million patients, including members of several Blue Cross and Blue Shield health plans. This breach included full names, email addresses, physical addresses, and telephone numbers. For some, it also includes Social Security Numbers (SSNs), Medicare/Medicaid ID numbers, and other health insurance […]
Last Friday, the American Hospital Association released a 9-page report detailing the increasing financial pressures the nation’s hospitals are facing due to rising reimbursement denials and delays from payers, including Medicare Advantage and commercial plans. Among other things, the report — which analyzed data from 1,300 hospitals across the country — found that the median
The American Hospital Association has issued a Special Bulleting alerting its members contracted with Medicare Advantage plans that they may have claims for reimbursement for underpayments under the 340B Drug Pricing Program. The Special Bulletin advised members: To assist members in this effort, we have identified and spoken with four outside law firm that have
Humana, Inc. has reported strong third quarter 2023 earnings, with its adjusted earnings per share of $7.78 beating analysts’ estimates. For the first three quarters of 2023, Humana has earned $3 billion in profit. Humana also announced that it expects to increase its Medicare Advantage membership to 860,000 in 2023, an increase of 19%, and
Beating analysts’ expectations, the Cigna Group reported strong profits of $1.4 billion and revenues of $49 billion for the third quarter of 2023. Through the first nine months of the year, Cigna reported $4.1 billion in profit and $144.2 billion in revenue. Cigna’s revenue growth was particularly strong in its health insurance business, Cigna Healthcare.
Whatley Kallas, LLP is representing 340B hospitals seeking recovery from Medicare Advantage plans for past underpayments for outpatient drugs. Now that CMS has issued its final rule requiring a one-time lump sum payment for the underpaid 340B drugs from the Medicare Program, it is time for 340B hospitals to demand these payments from Medicare Advantage
CVS Health Corporation reported strong third quarter 2023 profits of $2.3 billion. It also reported strong third quarter revenues of $89.8 billion, up 8.6% from the prior year quarter. Revenues are up 10.6% for the year compared with 2022. Both CVS Health’s third quarter profits and revenues beat analysts’ expectations. Revenues were also sharply up
In a strongly worded letter that includes specific examples of how prior authorization requirements harm patient care, the American Hospital Association has urged CMS to expeditiously finalize its Advancing Interoperability and Improving Prior Authorization Processes proposed rule. The proposed rule would generally apply to Medicare Advantage plans, state Medicaid and CHIP plans, and plans purchased
THE AHA URGES CMS TO EXPEDITIOUSLY FINALIZE ITS PROPOSED PRIOR AUTHORIZATION RULE Read More »
In response to federal court orders and input from providers, the Administration has issued proposed rules governing the Independent Dispute Resolution (“IDR”) process under the No Surprises Act (“the Act”), which should facilitate its use by providers. The IDR process was intended to resolve disputes between payers and providers regarding the amount insurers would pay
Following strong profits in 2022 and in the first half of 2023, UnitedHealth Group (“United”) again reported strong profits for the third quarter of 2023, with double-digit revenue growth at both UnitedHealthcare and Optum. United posted profits of $5.8 billion for the third quarter, an 11% increase from the prior year quarter. United also posted
UNITEDHEALTH GROUP REPORTS STRONG PROFITS FOR THE THIRD QUARTER OF 2023 Read More »