Medicare

Dialysis Patient Citizens Files Lawsuit Against HHS Secretary Alex Azar and CMS Administrator Seema Verma Over New Regulation That Undercuts Dialysis Patient Access to Affordable, High-Quality Care | PR Newswire | 6/23/2020

WASHINGTON , June 22, 2020 /PRNewswire/ – Today, Dialysis Patient Citizens (DPC) filed suit in the United States District Court for the District of Columbia against Health and Human Services Secretary Alex Azar , Centers for Medicare and Medicaid Services Administrator Seema Verma , the U.S. Department of Health and Human Services, and the Centers for Medicare and Medicaid Services in opposition to a discriminatory new federal regulation that will limit the ability of …

Verma: Fee-for-Service Medicare ‘Insufficient’ to Cover Vulnerable Beneficiaries Post-COVID | 6/23/2020

Early research into the impact of COVID-19 on seniors — both among the general population, and in nursing homes — has revealed endemic connections among race, income, and the likelihood of infection and death. Those patterns, reinforced by a new set of data probing COVID-19’s impact on Medicare beneficiaries, should prompt a more rapid move toward value-based care, Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma argued …

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Medicare coverage of COVID-19 testing for nursing home residents and patients | 6/23/2020

On Friday, June 19, 2020, CMS instructed Medicare Administrative Contactors and notified Medicare Advantage plans to cover coronavirus disease 2019 (COVID-19) laboratory tests for nursing home residents and patients. This instruction follows the CDC recent update of COVID-19 Testing Guidelines for Nursing Homes that provides recommendations for testing of nursing home residents and patients with symptoms consistent with COVID-19 as well as for asymptomatic residents and patients …

Big bills surprising COVID-19 survivors - UPI.com | 6/23/2020

… other items likely to make Flor’s bill even higher, the 70-year-old told Time. Advertisement But one fact provided Flor some solace: Kaiser Permanente, the health care company through which he receives his Medicare and Medicare Advantage coverage, has announced it will wave most out-of-pocket costs related to COVID treatment. That’s not going to be the case for a lot of folks who receive similarly high bills …

MA plans ordered to cover COVID-19 lab tests | 6/23/2020

Coronavirus lab tests for nursing home residents must be covered by Medicare Administrative Contractors and Medicare Advantage plans, the Centers for Medicare & Medicaid Services announced Friday. “Medicare Advantage plans must continue not to charge cost sharing (including deductibles, copayments, and coinsurance) or apply prior authorization or other utilization management requirements for COVID-19 tests and testing-related services,” the agency said. The move follows updated testing guidelines for nursing homes …

Coordinated-care groups decry $75M funding cut | Crain’s New York Business | 6/22/2020

… a massive cut. The 6% rate reduction would equate to about $11.5 million, he said. Other alternatives included reducing the number of people within the highest tier or reimbursement for services ($1.6 million), maximizing Medicare enrollment for individuals living in the community ($24.5 million) and maximizing Medicaid reimbursement through fee-for-service grants ($2.5 million). The result would be about the same in dollars for the state as its share …

Biden’s Mask Of Moderation Has Finally Slipped | Forbes | 6/22/2020

… healthcare task force is a haven for advocates of a government takeover of health insurance . Chief among them is Sen. Bernie Sanders, his former rival for the Democratic nomination. Sanders has been stumping for Medicare for All , and the abolition of private insurance, for decades. Donald Berwick, a former administrator of the Centers for Medicare and Medicaid Services under President Barack Obama, is another longtime advocate of single-payer on …

10 telemedicine billing questions and answers that are relevant right now | 6/22/2020

… telehealth has become an essential service for physicians and other health service workers. Still, with the rapid rise of the pandemic, many providers have difficulty navigating the billing side of telemedicine. While telehealth under Medicare legislation and policies continue to evolve , here are the latest answers to commonly asked questions during the COVID-19 PHE (public health emergency). 1. What exceptions does COVID-19 allow for? Telehealth is normally a …

Exclusive — Seema Verma: Cuomo, Other Democrat Governors’ Coronavirus Nursing Home Policies Contradicted Federal Guidance | 6/22/2020

… Exclusive — Seema Verma: Cuomo, Other Democrat Governors’ Coronavirus Nursing Home Policies Contradicted Federal Guidance 20,983 Alex Brandon/AP Photo Matthew Boyle 22 Jun 2020 Washington, DC Seema Verma, the administrator for the Centers for Medicare and Medicaid Services (CMS), told Breitbart News exclusively that New York’s Democrat Gov. Andrew Cuomo and other Democrat governors originally issued guidance that contradicted federal guidelines for nursing homes battling the coronavirus pandemic. “I just …

In U.S., 1 in 4 COVID-19 Deaths Are Residents of Nursing Homes | 6/22/2020

… that has borne a crushing burden from the pandemic. Most residents have been in lockdown since early March, isolated from families and friends, even in death. AP’s analysis of data from the Centers for Medicare and Medicaid Services found that nearly half of the more than 15,000 nursing homes have reported suspected or confirmed cases of COVID-19 as of June 7. About 1 in 5 facilities — or 21% — have …

Representative Donna Shalala & Representative Debbie Mucarsel-Powell’s staff meet with Americans for Medicare Advantage | 6/22/2020

… to engage South Florida’s congressional delegation – meeting with Rep. Donna Shalala herself and sitting down with the office of Rep. Debbie Mucarsel-Powell in February. During these meetings, Coalition members gave positive testimonials about Medicare Advantage to help Rep. Shalala and Rep. Mucarsel-Powell’s staff understand the importance of the program. Coalition members who met with Rep. Shalala pointed to the program’s prescription drug coverage and free fitness membership. These …

CMS Report Shows Increasing Racial Disparities in MA Plans | 6/22/2020

… take a hard look at health and access inequities. Meanwhile, CMS’s Office of Minority Research in April released a stratified report highlighting the racial and ethnic differences in health care experiences and care of Medicare Advantage (MA) enrollees. The data showed that black members enrolled in MA plans in 2018 received worse clinical care than white enrollees on 20 out of 44 measures, similar care for 20 and better care …

‘Ohana Health Plan Supports Communities in Need During COVID-19 Pandemic | PR Newswire | 6/22/2020

… more, visit https://www.wellcare.com/en/Hawaii/COVID-19 . About ‘Ohana Health Plan ‘Ohana Health Plan provides government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans (WellCare) across the state. ‘Ohana Health Plan is a wholly owned subsidiary of Centene Corporation, a leading multi-national healthcare enterprise committed to helping people live healthier lives. For …

2021 AHIP Certification Discounts | 6/22/2020

Looking for 2021 AHIP discounts and promotions? You’ve come to the right place. Our team searched high and low and located several AHIP discounts, promotions, and reimbursements that are available to Medicare agents for the 2021 AHIP. Most of these 2021 AHIP discounts are offered through a special link provided by carriers like UnitedHealthcare or Mutual of Omaha. 2021 AHIP Basics The 2021 AHIP Medicare Training certification opens Monday, June …

Another COVID Plague: Big Surprise Medical Bills for Survivors | 6/22/2020

… include other items likely to make Flor’s bill even higher, the 70-year-old told Time . But one fact provided Flor some solace: Kaiser Permanente, the health care company through which he receives his Medicare and Medicare Advantage coverage, has announced it will wave most out-of-pocket costs related to COVID treatment. That’s not going to be the case for a lot of folks who receive similarly high bills …

Medicare Advantage and Reimbursement to Address Social Risk Factors | 6/22/2020

Medicare Advantage and Reimbursement to Address Social Risk Factors Care Mag We don’t always think of health insurers as communicators. However, when insurers set reimbursement rates, they provide information that directly influences service …

Emergency Declarations and Waiver Authority | 6/22/2020

The Centers for Medicare and Medicaid Services (CMS) has issued more than 100 waivers giving healthcare providers the flexibility to meet the demands presented by the Coronavirus (COVID-19) pandemic. These waiver flexibilities are temporary, however. The authority to grant public health emergency-based waivers under §1135 of the Social Security Act is provided to the Secretary of Health and Human Services (HHS) when two things are true: the Secretary …

Compliance Alert: HHS Finalizes Its Updated Section 1557 Rules | 6/22/2020

… 1557 Covered Entities Under prior HHS Rules (issued in 2016) Section 1557 of the ACA applied to “covered entities,” which were defined as health programs or activities that receive “federal funding” from HHS (except Medicare Part B payments), including state and federal Marketplaces. Examples include hospitals, health clinics, community health centers, group health plans, health insurance issuers, physician’s practices, nursing facilities, as well as employers with respect to their own …

2020 Protocols for the Medicare Part C and Part D Program Audits, Medicare-Medicaid Plan Program Audits, and Part C Timeliness Monitoring Project | 6/22/2020

On Friday, June 16, 2020, CMS posted the much anticipated and long-awaited approval of the 2020 Protocols for the Medicare Part C and Part D Program Audits, Medicare-Medicaid Plan Program Audits, and Part C Timeliness Monitoring Project. CMS has also finalized the Contract Year 2020 program audit protocols for Medicare-Medicaid Plans (MMPs). These protocols and supporting data collection will be used for Medicare Part C and Part …

CMS releases inaugural-year evaluation of BPCI Advanced | 6/22/2020

CMS releases inaugural-year evaluation of BPCI Advanced Jun 22, 2020 - 02:33 PM The Centers for Medicare & Medicaid Services last week released the first annual report evaluating the Bundled Payments for Care Improvement Advanced Model. The alternative payment model, launched in October 2018 by the Center for Medicare and Medicaid Innovation, tests whether linking Medicare provider payments with episodes of care can reduce Medicare expenditures while improving quality. The report …

Medicare to cover COVID-19 tests for nursing home patients | 6/22/2020

Beginning July 6, both traditional Medicare and Medicare Advantage plans will cover diagnostic COVID-19 laboratory tests for nursing home residents and patients through the remainder of the public health emergency, the Centers for Medicare & Medicaid Services announced Friday. The Centers for Disease Control and Prevention recently recommended testing all nursing home residents and patients with COVID-19 symptoms or potential exposure. MA plans must continue not to charge cost …

CDC: Emergency department visits for life-threatening conditions declined in pandemic’s early months | 6/22/2020

Beginning July 6, both traditional Medicare and Medicare Advantage plans will cover diagnostic COVID-19 laboratory tests for nursing home residents and… Headline Clinical laboratories and health care providers should stop using any antibody tests on the Food and Drug Administration’s “removed” test list, evaluate prior… Headline A study of the first 20,000 adults hospitalized with severe or life-threatening COVID-19 to receive convalescent plasma found the investigational therapy …

Study: Convalescent plasma safe for patients with severe COVID-19 | 6/22/2020

Beginning July 6, both traditional Medicare and Medicare Advantage plans will cover diagnostic COVID-19 laboratory tests for nursing home residents and… Headline Clinical laboratories and health care providers should stop using any antibody tests on the Food and Drug Administration’s “removed” test list, evaluate prior… Headline A new study released today by the Centers for Disease Control and Prevention shows emergency department visits dropped by 23% for heart attacks …

Rural Markets May Offer Huge Upside for Home Care Providers Looking to Break into Medicare Advantage | Home Health Care News | 6/22/2020

Many home care providers jumped at the chance to create new Medicare Advantage (MA) business lines after the U.S. Centers for Medicare & Medicaid Services (CMS) began making supplemental benefits more flexible more than two years ago. Now, those same providers that got into MA early are beginning to better understand the space while hunting for different ways to boost their bottom lines. Some, for example, see robust opportunity in home …

Big Surprise Medical Bills for COVID Survivors | WebMD | 6/22/2020

… include other items likely to make Flor’s bill even higher, the 70-year-old told Time . But one fact provided Flor some solace: Kaiser Permanente, the health care company through which he receives his Medicare and Medicare Advantage coverage, has announced it will waive most out-of-pocket costs related to COVID treatment. That’s not going to be the case for a lot of folks who receive similarly high bills …

Medicaid

Coordinated-care groups decry $75M funding cut | 6/22/2020

Medicare enrollment for individuals living in the community ($24.5 million) and maximizing Medicaid reimbursement through fee-for-service grants ($2.5 million). The result would be about the same in dollars for the state as its share of the $75 million (split 50-50 with federal reimbursement). The proposal is viable and would have less effect on the quality of services provided, Grossman said. The seven CCOs were established two years ago …

Kaiser Family Foundation

Healthcare’s Post-COVID-19 Margin Recovery Plan: Permanent Digitally-Enabled Cost Take-outs that Win with Patients - Industry Analysis by Loyale Healthcare | 5/20/2020

… And although losses for many have been reduced by funding through the CARES Act and accelerated payments and incentives from Medicare/Medicaid, the financial damage wreaked by the crisis will take a long time to … only gotten worse. According to a report published by the Kaiser Family Foundation , “Between March 1 and May 2, 2020, more than 31 million people had filed for unemployment insurance”, going on to estimate that …

American Hospital Association

Healthcare’s Post-COVID-19 Margin Recovery Plan: Permanent Digitally-Enabled Cost Take-outs that Win with Patients - Industry Analysis by Loyale Healthcare | 5/20/2020

… industry, the COVID-19 crisis has driven the industry into a financial crisis. According to analysis just published by the American Hospital Association (AHA), the effects of COVID-19 hospitalization costs, cancelled and forgone services … through the CARES Act and accelerated payments and incentives from Medicare/Medicaid, the financial damage wreaked by the crisis will take a long time to overcome. Patients are struggling financially too. Long before the crisis …

Patient Engagement

Humana, Healthmap team up on Florida kidney care coordination program | FierceHealthcare | 5/20/2020

… is teaming up with Healthmap Solutions, a specialty population health management company, to offer a new care coordination program for Medicare Advantage and commercial members in Florida with kidney disease. Healthmap’s platform fills gaps in … example, improved patient medication adherence — and the member experience, including patient engagement, awareness of care options, and more,” Agarwal said. Read more on …

American Academy of Pediatrics

How Children’s Hospital Los Angeles Is Keeping Families Safe During COVID-19 | Business Wire | 5/19/2020

… American Academy of Pediatrics, the U.S. Surgeon General and the Centers for Medicare and Medicaid Services have all stated that it is important to address in a timely manner health care that was previously postponed,” says Paul S. Viviano , President and CEO of Children’s Hospital Los Angeles. “Throughout this crisis, Children’s Hospital Los Angeles has been dedicated to ensuring a safe environment for our young patients, their families and all …

Department of Health and Human Services

Northwell hospitals receive NY’s greatest share of federal hot spot funding | 5/18/2020

… of the most Covid-19 patients. Its award was the largest among hospital systems out of the $5 billion the Department of Health and Human Services sent to New York, according to a Crain’s analysis … billion was set aside for hospitals treating disproportionate shares of Medicare, Medicaid and uninsured patients. A previous round of $50 billion federal funding had calculated awards based on providers’ share of all U.S. Medicare payments …

Community Health

Northwell hospitals receive NY’s greatest share of federal hot spot funding | 5/18/2020

… to the crisis. Of the $12 billion distributed nationally, $2 billion was set aside for hospitals treating disproportionate shares of Medicare, Medicaid and uninsured patients. A previous round of $50 billion federal funding had calculated … requested that information from the Cuomo administration on behalf of community health organizations. Uttley said the Covid-19 outbreak has shown the need for more thoughtful regional health planning that spans both public and private …

CDC

VHCA-VCAL, LeadingAge Virginia, and VALA Statement on Licensed Nursing Homes Dashboard | 5/18/2020

Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) via the National Healthcare Safety Network (NHSN). Virginia’s assisted living facilities are also reporting cases to their local health departments and to the Virginia Department of Social Services, as well as reporting their personal protective equipment (PPE) burnrate and inventory to DSS. Assisted living facilities may choose to use the NHSN. It is important to note …

Food and Drug Administration

‘We need a comprehensive battle strategy’: States opening their economies lack benchmarks for reimposing restrictions - The Washington Post | 5/15/2020

Food and Drug Administration and administrator of the Centers for Medicare and Medicaid Services under President George W. Bush, said state leaders know “they may need to pause or even step back.” AD Sign up for our Coronavirus Updates newsletter to track the outbreak. All stories linked in the newsletter are free to access. “But we haven’t seen a whole lot of detail on those specific plans in most states …

ACOs

Providers press CMS to extend deadline on whether an ACO can quit to Oct. 31 | 5/14/2020

Providers press CMS to extend deadline on whether an ACO can quit to Oct. 31 by Robert King May 14, 2020 4:05pm Provider groups say accountable care organizations should be given an option on how to handle repaying losses to Medicare for not meeting spending targets. (Getty/Ca-ssis) Provider groups say accountable care organizations (ACOs) need until Oct. 31 to decide whether to leave the Medicare Shared Savings Program …

ACO

Providers press CMS to extend deadline on whether an ACO can quit to Oct. 31 | 5/14/2020

Providers press CMS to extend deadline on whether an ACO can quit to Oct. 31 by Robert King May 14, 2020 4:05pm Provider groups say accountable care organizations should be given an option on how to handle repaying losses to Medicare for not meeting spending targets. (Getty/Ca-ssis) Provider groups say accountable care organizations (ACOs) need until Oct. 31 to decide whether to leave the Medicare Shared Savings Program …

Telehealth

Amidst COVID-19, Health Insurance Needs Automated Transformation | 5/7/2020

… products, services, and support in the healthcare sector. While this crisis has led to ground-breaking surges in options like telehealth, Ensurem, LLC suggests that the health insurance process should be automated in order to … as recently determined by the Trump administration, the Centers for Medicare & Medicaid Services (CMS) broadened access to Medicare telehealth services so that beneficiaries are able to receive a wider range of services from their doctors …

HIPAA

UPDATED Coronavirus tracker: Oscar, Uno partner on MA financial assistance; HHS awards more than $580M to expand testing | FierceHealthcare | 5/7/2020

UPDATED: Thursday, May 7 at 1:55 p.m. Oscar, Uno partner to offer financial assistance to Medicare Advantage members Oscar has teamed up with Uno Health to officer financial assistance to its Medicare Advantage members impacted … HHS allows business partners to share COVID patient data under HIPAA The Department of Health and Human Services has taken steps to provide guidance for healthcare business associates, such as collections agencies, financial institutions, and …

Readmissions

Telehealth service for nursing homes reduces hospital admissions, freeing capacity for COVID-19 response | 5/6/2020

… and costly transportation to physician offices. Maxwell places an on-site professional in each facility to perform assessments of patients’ likelihood of readmission, which may trigger a preemptive intervention by clinical staff. With Medicare recently being directed to reimburse for telehealth visits to nursing homes and other senior facilities and relax regulations to allow physicians to practice telemedicine in states where they are not licensed, it is much easier to …

Continuum of Care

OneOncology Names Jeff Patton, MD as CEO | PR Newswire | 5/6/2020

… for approximately 250,000 patients annually at 160 sites of care. OneOncology partner practices deliver integrated oncology care services across the continuum of care from screening and diagnosis to clinical trials and therapies to survivorship or … what will propel our future growth.” As the Centers for Medicare and Medicaid Services (CMS) and private payers move more toward reimbursing for episodes of care rather than services provided, OneOncology practice physicians have demonstrated …

ACA

$820M Payer Acquisition Boosts Medicaid Portfolios Amid COVID-19 | 5/5/2020

… News $820M Payer Acquisition Boosts Medicaid Portfolios Amid COVID-19 Molina is using the deal to expand its Medicaid and Medicare portfolios as coronavirus drives Medicaid enrollment higher. 05, 2020 - Molina Healthcare, Inc. announced that … become uninsured due to coronavirus are turning to Medicaid and ACA exchange plans for coverage. More than especially vulnerable industries, such as retail, restaurants, and home health care services, are Molina expressed awareness of this …

Home Health

$820M Payer Acquisition Boosts Medicaid Portfolios Amid COVID-19 | 5/5/2020

… News $820M Payer Acquisition Boosts Medicaid Portfolios Amid COVID-19 Molina is using the deal to expand its Medicaid and Medicare portfolios as coronavirus drives Medicaid enrollment higher. 05, 2020 - Molina Healthcare, Inc. announced that … More than especially vulnerable industries, such as retail, restaurants, and home health care services, are Molina expressed awareness of this trend as it took on its new Medicaid and Medicare plans. “Molina’s strengths and capabilities …

Ohio State University

Spring Venture Group Announces New Chief Marketing Officer | 5/5/2020

… Venture Group’s executive leadership team. As CMO, Grant will direct the marketing programs for SVG and its insurance brands: United Medicare Advisors and SmartMatch Insurance Solutions. His responsibilities include guiding brand management, driving content and … service its brands are known for.” Grant graduated from the Ohio State University with a B.A. degree and holds an M.B.A. from Lehigh University. About Spring Venture Group Spring Venture Group ( SVG ) is the Parent …

MedPAC

The Grim Post-COVID-19 Future For Nursing Homes | 5/4/2020

… Medicare. For many facilities—though not all—it is quite profitable. Traditional fee-for-service Medicare pays about $500-a-day, although Medicare managed care—a growing share of the business—pays closer to $400. Overall, average Medicare margins in 2017 were about 11 percent , according to the Medicare Payment Advisory Commission (MedPAC), a group that advises Congress. By contrast, Medicaid pays at least some costs for about 80 percent …

National Cancer Institute

Insight into FDA’s Revised Policy on Antibody Tests: Prioritizing Access and Accuracy | PR Newswire | 5/4/2020

… was intended to limit antibody testing to laboratories certified under the Clinical Laboratory Improvement Amendments (CLIA) by the Centers for Medicare and Medicaid Services (CMS) to perform testing in high-complexity and point-of-care … and Development Authority to help establish a capability at the National Cancer Institute (NCI) for the U.S. Government to independently validate certain antibody tests, including antibody tests that were not the subject of an EUA …

Mental Health

Centene To Invest In Critical Mental Health Resources | 5/4/2020

Centene To Invest In Critical Mental Health Resources Centene partners with organizations across the country to support their respective mental health efforts during COVID-19 pandemic News provided by May 04, 2020, 07:00 ET Share … 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace, the TRICARE program, and individuals in …

Rural Health

COVID Latest Threat to Weakened Rural Health Care | 5/4/2020

Rural Health Research Program. The Centers for Medicare and Medicaid Services (CMS) has designated at least 1,350 of the estimated 2,000 rural hospitals nationwide as “critical access hospitals” that have 25 or fewer beds and are more than 35 miles, or 15 miles by mountainous terrain or secondary roads, from the next nearest hospital. “These hospitals are designed for primary care and surgery, not pandemics. Most of the care is …

Behavioral Health

Centene To Invest In Critical Mental Health Resources | 5/4/2020

… potential mental health crises Expanding access to Mental Health First Aid (MHFA) – An investment to help the National Council for Behavioral Health (NCBH) transition part of their training program to a virtual program, which will … 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace, the TRICARE program, and individuals in …

National Committee for Quality Assurance

Why primary care needs a prospective payment system | Modern Healthcare | 5/2/2020

… primary-care physician by background. I have a group called Village Health Partners that I founded. We were the first National Committee for Quality Assurance Level-3 medical home in the middle part of the … work with) Blue Cross and Blue Shield, UnitedHealthcare, Cigna, Aetna, Medicare Advantage, Medicare shared savings. Since we (have all of those) lives under contract, the physician practices can have a single model to take care …

Population Health

CMS removes COVID-19 inpatient treatment from ACO performance calculations | 5/2/2020

… interim rule is extending the mitigation of shared losses back to January 2020. Susan Morse , Managing Editor The Centers for Medicare and Medicaid Services has released an interim final rule to remove spending associated with … their public health emergency response while maintaining their investments in population health .” Twitter: @SusanJMorse News Once-failing hospitals say accountability, transparency key to surviving fallout from failing patient safety grades When Leapfrog released their Spring …

UnitedHealth

Study Finds Seniors with COVID-19 Taking Hypertension Medication at Lower Risk of Hospitalization, Clinical Trial to Follow Immediately | Business Wire | 5/19/2020

UnitedHealth Group (NYSE: UNH) with the Yale School of Medicine found that older COVID-19 patients with hypertension taking angiotensin-converting enzyme (ACE) inhibitors had a lower risk of COVID-19 hospitalization. A pragmatic clinical trial will be a critical next step. The study, which was recently submitted for peer-reviewed publication, analyzed retrospective data from about 10,000 patients testing positive for SARS-CoV-2 who were enrolled in Medicare

UnitedHealth Group

Study Finds Seniors with COVID-19 Taking Hypertension Medication at Lower Risk of Hospitalization, Clinical Trial to Follow Immediately | Business Wire | 5/19/2020

UnitedHealth Group (NYSE: UNH) with the Yale School of Medicine found that older COVID-19 patients with hypertension taking angiotensin-converting enzyme (ACE) inhibitors had a lower risk of COVID-19 hospitalization. A pragmatic clinical trial will be a critical next step. The study, which was recently submitted for peer-reviewed publication, analyzed retrospective data from about 10,000 patients testing positive for SARS-CoV-2 who were enrolled in Medicare

Anthem, Inc.

Humana (HUM) Rallies 59.3% in a Year: Further Upside Left? - May 18, 2020 - Zacks.com | 5/18/2020

Humana Inc. ( HUM - Free Report ) is well-poised for growth on the back of its robust Medicare business and strategic initiatives. Shares of this Zacks Rank 2 (Buy) company have surged 59.3% in a year’s time, outperforming its industry ‘s increase of 13%. The price performance looks stellar when compared to other companies’ stock movements in the same space, such as Anthem, Inc. ( ANTM - Free Report ) , Centene Corporation ( CNC - Free …

Medline

The World Market for Surgical Masks (2015-2025): Unprecedented Demand for N-95 Masks due to the Outbreak of COVID-19 | PR Newswire | 5/12/2020

Medicare Hygiene Limited, Mediblue Health Care Private Limited, Medline Industries Inc., Plasti Surge Industries Pvt. Ltd., Premium Health Care Disposables Private Limited, Smith and Nephew, Molnlycke Healthcare, Halyard Healthcare, Ansell Healthcare, Honeywell International, Johnson and Johnson, Karl Storz , Lac-Mac, Sempermed, DUKAL Corporation, C.R. Bard and others. The companies are developing advanced technologies and launching new services in order to stay competitive in the market. Other competitive strategies include mergers …

Wolters Kluwer

Wolters Kluwer Taps Marc ‘Frank’ Jackson to Lead ONC Interoperability & Payer Solutions at Health Language | Business Wire | 5/7/2020

WALTHAM, Mass.- Wolters Kluwer, Health today announced that Marc ‘Frank’ Jackson has joined the organization as Vice President and General Manager for its Health Language business. As health systems and payers navigate a landscape of changing government policies, such as the recent interoperability rulings by the Office of the National Coordinator (ONC) and the Centers for Medicare and Medicaid Services (CMS), Jackson will drive strategic initiatives that leverage Health Language …

CVS

CVS Health Reports First Quarter Results, Provides Update On COVID-19 Response 2020 Full Year EPS Guidance Remains Unchanged | 5/6/2020

… 19 on the Company’s financial statement line items and related ratios, 2020 additional detailed guidance not noted above is withdrawn CVS Health Corporation (NYSE: CVS ) today announced operating results for the three months ended March … by the absence of the financial results of Aetna’s standalone Medicare Part D prescription drug plans, which the Company retained through 2019, membership declines in the segment’s Commercial insured products, as well as a decline …

DaVita

DaVita Inc. COVID-19 Response Efforts and 1st Quarter 2020 Results | 5/6/2020

DENVER , May 5, During the first quarter of 2020, DaVita Inc. (NYSE: DVA ) took significant steps to respond to the novel coronavirus (COVID-19) pandemic while continuing to provide high-quality care for its patients … U.S. Department of Health and Human Services, the Centers for Medicare and Medicaid Services, Centers for Disease Control and Prevention, and dialysis providers nationwide to help ensure that the dialysis community is able to support …

CVS Health

CVS Health Reports First Quarter Results, Provides Update On COVID-19 Response 2020 Full Year EPS Guidance Remains Unchanged | 5/6/2020

… 19 on the Company’s financial statement line items and related ratios, 2020 additional detailed guidance not noted above is withdrawn CVS Health Corporation (NYSE: CVS ) today announced operating results for the three months ended March … by the absence of the financial results of Aetna’s standalone Medicare Part D prescription drug plans, which the Company retained through 2019, membership declines in the segment’s Commercial insured products, as well as a decline …

Walmart Health

Retail giant Walmart got $12.6 million in federal health stimulus cash intended for doctors and hospitals, but decided to give it back | Business Insider | 5/5/2020

Walmart provides some healthcare services, but decided to return the money. Shoshy Ciment/Business Insider Walmart received $12.6 million from a coronavirus relief fund Congress set up to help struggling doctors and hospitals. Walmart got the money because the formula the Trump administration set up allowed any healthcare providers who take care of Medicare patients to qualify. The funds went out automatically. Even though Walmart provides healthcare and set up …

Alignment Healthcare

Health-insurance startups like Oscar and Clover have raked in billions in venture funding. We dug into their financials, which show why 2020 stands to be a pivotal year for the insurers. | Business Insider | 5/5/2020

… now. We took a look at 2019 financial results for startups Oscar Health, Devoted Health, Bright Health, Clover Health, and Alignment Healthcare. Collectively, the companies have raised $4 billion to use technology to build new … Care Act’s markets and to seniors in the form of Medicare Advantage health plans. The financial results also provide some clues about where the insurance startups might expand over the coming years. To be sure …

Aledade

3 Ways to Boost Interoperability to Aid COVID-19 Containment | EHR Intelligence | 5/4/2020

… effort, despite valiant attempts to cobble together information from many disparate systems.” The authors, who included the likes of current Aledade founder and former ONC head Farzad Mostashari, MD, and Mark McLellan, the Margolis Center … care testing manufacturers. The pair also say the Centers for Medicare and Medicaid Services (CMS) and private payers should also establish incentives and payment adjustments that would provide missing information for the providers that conduct …

Reliq Health

Reliq Health Technologies, Inc. Announces 8 New Contracts in Texas, New iUGO Care Module | Globe Newswire | 4/30/2020

HAMILTON, Ontario, April 30, 2020 (GLOBE NEWSWIRE) – Reliq Health Technologies Inc. (TSXV:RHT or OTCQB:RQHTF) (“ Reliq ” or the “ Company ”), a technology company focused on developing innovative mobile health (mHealth) and telemedicine solutions for Community … billing codes for PCM were introduced by the Centers for Medicare and Medicaid Services (CMS) in 2020. These codes allow specialists to provide care management services to patients with one high risk disease or complex …

Quest Diagnostics

Clinical Genomics Expands Strategic Relationship with Quest Diagnostics and Further Increases Momentum for Innovative First-Line Colorectal Cancer Screening Blood Test | Globe Newswire | 4/30/2020

Advances key development milestones for the Trident Program – – Further strengthens strategic alliance with Quest Diagnostics focused on the Trident Program for CRC screening – BRIDGEWATER, N.J., Clinical Genomics (“CG” or the “Company”), a provider of advanced … U.S. Food and Drug Administration (“FDA”) and the Centers for Medicare and Medicaid Services (“CMS”) to finalize clinical study design with the goal of securing U.S. Premarket Approval (“PMA”) and a National Coverage Determination (“NCD …

Teladoc

Teladoc hikes 2020 guidance after seeing visits double in Q1 | Healthcare Dive | 4/30/2020

Teladoc hikes 2020 guidance after seeing visits double in Q1 Author share Dive Brief: Teladoc significantly raised its full-year guidance on Wednesday despite skating underneath Wall Street expectations on earnings for the first quarter … up 61% year over year, including roughly half a million Medicare Advantage members. The company expects to end 2020 with at least 50 million members — 13.3 million more than 2019. In the U.S., revenue from …

DispatchHealth

Tivity Health and DispatchHealth Partner to Provide Patient Nutrition Support | PR Newswire | 4/29/2020

… Tivity Health ® (Nasdaq: TVTY ) , a leading provider of nutrition, fitness and social engagement solutions, today announced a new partnership with DispatchHealth, a provider of technology-enabled in-home health care, to deliver healthy, convenient meals … need of quality meals and nutritional support.” Hospital readmissions cost Medicare $26 billion annually , with about $17 billion spent on avoidable hospital trips due to malnutrition after discharge. With the partnership, Tivity Health will be …

WebMD

COMMENTARY: Why I Founded United Physicians and Why You Should Join | WebMD | 4/29/2020

… have strong opinions but rarely agree. Like much of the country, physicians are divided on the big issues: Many support Medicare for all, while a large group believes that Medicare should be boycotted. What would … more meaningful recertification and lifelong learning. Medscape Medical News © 2020 WebMD, LLC. All rights reserved. Pagination …

Biogen

Everbridge Announces General Colin L. Powell, USA (Ret.) and Scott Gottlieb, M.D., as Keynote Speakers for its Virtual COVID-19 “Road to Recovery” Executive Summit on May 20-21 | Business Wire | 4/29/2020

… roadmap to recovery. The keynote speakers will be joined by C-level executives from a variety of organizations, including Accenture, Biogen, The Boston Celtics and Russell Reynolds Associates, as well as global government and healthcare … a Senior Adviser to the Administrator of the Centers for Medicare and Medicaid Services, where he helped advance policies to improve healthcare quality and promote the effective use of new medical technologies. A healthcare futurist …

Chemed Corporation

Chemed’s (CHE) Q1 Earnings Beat Estimates, Margins Improve - April 29, 2020 - Zacks.com | 4/29/2020

Chemed Corporation ( CHE - Free Report ) reported first-quarter 2020 adjusted earnings per share (EPS) of $3.68, up 26% year over year. The figure beat the Zacks Consensus Estimate by 2.2%. The company’s GAAP EPS was … was driven by a 5% increase in geographically weighted average Medicare reimbursement rate, 5.9% rise in days-of-care and acuity mix shift. However, decline in Medicare Cap, increase in Medicaid net room and board …

SilverSneakers

Tivity Health and DispatchHealth Partner to Provide Patient Nutrition Support | 4/29/2020

… support their efforts and improve the health of patients in need of quality meals and nutritional support.” Hospital readmissions cost Medicare $26 billion annually , with about $17 billion spent on avoidable hospital trips due to … is a leading provider of healthy life-changing solutions, including SilverSneakers ® , Nutrisystem ® , Prime ® Fitness, Wisely Well ™ , South Beach Diet ® and WholeHealth Living ® . We are actively addressing the social determinants of health, defined as the conditions …

Edifecs

Commonwealth of Pennsylvania Partners with Edifecs to Provide EDI Module Services | Business Wire | 4/29/2020

BELLEVUE, Wash.–(BUSINESS WIRE)–Apr 29, 2020– Edifecs, Inc., a global health information technology solutions company, announced that it has been selected by the Department of Human Services of the Commonwealth of Pennsylvania to implement … maintenance for the EDI Module. Achievement of the Centers for Medicare and Medicaid Services (CMS) certification for the EDI Module and operations continuity with the MMIS 2020 Platform post-implementation. Assurance that EDI services provide …

Xtelligent Healthcare Media

Medicaid, CHIP Amendments Help States Fight COVID-19 Outbreak | HealthPayer Intelligence | 4/29/2020

… programs flexibility to better respond to COVID-19. For more coronavirus updates, visit our resource page , updated twice daily by Xtelligent Healthcare Media. Many private payers have waived member payment for COVID-19 testing and … restrictive despite it being a known solution. The Centers for Medicare and Medicaid Services (CMS) have, therefore, recently approved over 125 waivers and amendments to state Medicaid and CHIP programs that expand coverage options and …

LabCorp

CVS, Walgreens pledge to ramp up COVID-19 testing efforts as White House takes aim at reopening economy | FierceHealthcare | 4/28/2020

… said that more than 5.4 million COVID-19 tests have been performed in the past 45 days. RELATED: CMS boosts Medicare payments for high-throughput COVID-19 diagnostic tests At the briefing, representatives from major … 49 states and Puerto Rico and announced a partnership with LabCorp that the pharmacy chain said should triple its testing capacity. Walgreens will work with the administration to establish the new testing sites, which it …

Omada Health

Lark Health study shows impact of virtual diabetes prevention program on underserved population | FierceHealthcare | 4/27/2020

Startups have been lobbying for federal policymakers to allow Medicare reimbursement for virtual and digital diabetes prevention programs—particularly in light of the COVID-19 crisis. Now, digital health startup Lark Health says it has … is the highest level of recognition from the agency. Startup Omada Health also has gained full recognition status from the CDC for its DPP program, as well as Fruit Street Health. Weight loss is used …

Avalere Health

Medicare Advantage insurers tested by flood of kidney failure patients | Modern Healthcare | 4/27/2020

Print DaVita Kidney Care A DaVita Kidney Care clinician tends to a dialysis patient. Medicare spending on kidney disease totaled more than $114 billion in 2016. A corner of the health insurance industry that has … for them, said Sean Creighton, a managing director at consultancy Avalere Health and former CMS official. “This is about more than payment,” Creighton said. Insurers “have to look at building networks of nephrologists; they have …

Apple Health

Slavitt, Gottlieb Seek Money For Contact Tracing, Self-Isolation : NPR | 4/27/2020

Apple Podcasts Google Podcasts Pocket Casts Spotify RSS link Ex-Officials Call For $46 Billion For Tracing, Isolating In Next Coronavirus Package Facebook Twitter Flipboard Email April 27, 2020 5:13 AM ET Franco Ordoñez Twitter Instagram Enlarge this image “If we want to get back to a more normal existence, we need to give states the tools they need to contain the virus,” Andy Slavitt, a former director of Medicare

William Blair

Labs welcome CMS rate for coronavirus antibody testing – Safety Health News | Healthcare Dive | 5/21/2020

Labs welcome CMS rate for coronavirus antibody testing May 21, 2020 Dive Brief: CMS set the reimbursement rate for Medicare Administrative Contractors covering the main type of coronavirus antibody test at approximately $42, per an update Tuesday. That rate exceeds investment firm William Blair’s $25 estimate for the category of tests, boding well for future reimbursement policy for antigen testing, analysts noted. Last month, the agency doubled its reimbursement for …

Morgan Stanley

Live updates on COVID-19: April 1-15 | Modern Healthcare | 5/5/2020

… every shift. Several local news outlets also believe some states are undercounting the number of people succumbing to the disease. Morgan Stanley’s estimates on outbreak recovery Morgan Stanley: “While we understand the desire for optimism … Act would be distributed based on providers’ share of nationwide Medicare payments. The New York delegation highlighted that their state has seen the highest number of cases and deaths from COVID-19 nationwide. “Our hospitals …

Goldman Sachs

Edited Transcript of SAN.PA earnings conference call or presentation 24-Apr-20 12:30pm GMT | 5/2/2020

… Jacques Le Fur Bryan Garnier & Co Ltd, Research Division - Analyst Jo Walton Crédit Suisse AG, Research Division - MD Keyur Parekh Goldman Sachs Group Inc., Research Division - Equity Analyst Laura Sutcliffe UBS Investment Bank, Research Division … split for the U.S. pharma is roughly 40% commercial, 40% Medicare, 20% Medicaid. Just given the importance of DUPIXENT to the Sanofi growth story near term and the risk to the commercial book of business …

JP Morgan Chase

Edited Transcript of SAN.PA earnings conference call or presentation 24-Apr-20 12:30pm GMT | Yahoo News | 5/2/2020

… Analyst Laura Sutcliffe UBS Investment Bank, Research Division - Equity Research Analyst Peter Verdult Citigroup Inc, Research Division - MD Richard Vosser JP Morgan Chase & Co, Research Division - Senior Analyst Seamus Christopher Fernandez Guggenheim Securities, LLC, Research … split for the U.S. pharma is roughly 40% commercial, 40% Medicare, 20% Medicaid. Just given the importance of DUPIXENT to the Sanofi growth story near term and the risk to the commercial book of business …

Citigroup

Edited Transcript of SAN.PA earnings conference call or presentation 24-Apr-20 12:30pm GMT | Yahoo News | 5/2/2020

… Goldman Sachs Group Inc., Research Division - Equity Analyst Laura Sutcliffe UBS Investment Bank, Research Division - Equity Research Analyst Peter Verdult Citigroup Inc, Research Division - MD Richard Vosser JP Morgan Chase & Co, Research Division - Senior Analyst … split for the U.S. pharma is roughly 40% commercial, 40% Medicare, 20% Medicaid. Just given the importance of DUPIXENT to the Sanofi growth story near term and the risk to the commercial book of business …

JP Morgan

Edited Transcript of SAN.PA earnings conference call or presentation 24-Apr-20 12:30pm GMT | Yahoo News | 5/2/2020

… Analyst Laura Sutcliffe UBS Investment Bank, Research Division - Equity Research Analyst Peter Verdult Citigroup Inc, Research Division - MD Richard Vosser JP Morgan Chase & Co, Research Division - Senior Analyst Seamus Christopher Fernandez Guggenheim Securities, LLC, Research … split for the U.S. pharma is roughly 40% commercial, 40% Medicare, 20% Medicaid. Just given the importance of DUPIXENT to the Sanofi growth story near term and the risk to the commercial book of business …

Merrill Lynch

Edited Transcript of SAN.PA earnings conference call or presentation 24-Apr-20 12:30pm GMT | Yahoo News | 5/2/2020

… SVB Leerink LLC, Research Division - Director of Therapeutics Research & Diversified Biopharma and Senior Research Analyst Graham Glyn Charles Parry BofA Merrill Lynch, Research Division - MD and Head of Healthcare Equity Research Jean-Jacques Le Fur … split for the U.S. pharma is roughly 40% commercial, 40% Medicare, 20% Medicaid. Just given the importance of DUPIXENT to the Sanofi growth story near term and the risk to the commercial book of business …

Echo Health Ventures

Aledade Raises $64 Million Series C on Nationwide Growth of Value-Based Care Network | PR Newswire | 4/20/2020

… Organizations (ACOs). OMERS Growth Equity led the round, which included strategic investors California Medical Association , and returning investors Meritech Capital , Echo Health Ventures , CVF, and GV . “When we started Aledade nearly six years ago, we … more than $7.5 billion in health care spending through 38 Medicare and 42 other value-based contracts. The funding round comes as Aledade has experienced over 60 percent annual growth in revenue, as well as …

Google Ventures

Aledade scores $64M funding round with Google, California Medical Association as backers | FierceHealthcare | 4/20/2020

… Medicare, Medicare Advantage, Medicaid, and commercial health plans. (Sergei Domashenko/Shutterstock) Google-backed Aledade, the startup company that is working to reshape primary care, landed a $64 million series C funding round. OMERS Growth Equity led the round which included strategic investors Echo Health Ventures and the California Medical Association, and returning investors Meritech Capital and GV (formerly Google Ventures). Aledade , based in Bethesda, Maryland, partners with independent primary care …

SVB Leerink

Teladoc, Livongo execs highlight bright spots for health IT amid pandemic | Healthcare Dive | 4/16/2020

share Dive Brief: Virtual health adoption is accelerating among both providers and consumers — especially among those that pushed back on the model just months prior, SVB Leerink analysts wrote after speaking with management teams from Teladoc Health, Health Catalyst and Livongo Health. While regulatory relief in the form of relaxed state-lines rules and expanded telehealth reimbursement for Medicare have made the services more accessible, speakers said they don’t expect …

NCI

COVID-19 Pandemic: Prevent the Oncoming Medical Information Crisis | HIT Consultant | 3/31/2020

… to learn from hospital records, but they would also need to sift through the electronic records of government programs like Medicare and Medicaid. Like the hospitals, most of these institutions will be unable to easily … such as ICD10, ICD10 PCS, SNOMED, LOINC, RxNorm, CPT, or NCI to ensure interoperability and portability of this data. Thus, they could be machine-readable and quickly analyzed for key insights. Permit and encourage physicians …

Thrive Capital

Cleveland Clinic-Oscar Health partnership shows success in concierge medicine | Modern Healthcare | 3/9/2020

… traditional, fee-for-service, contractual relationships with most of its other payers, which are insurance companies or government programs like Medicare and Medicaid. Under the fee-for-service business model, insurers pay providers for each … New York City in 2012, a year after Kushner started Thrive Capital Management LLC , where he is managing partner. Oscar Health is rooted in dissatisfaction with the health insurance industry. In 2012, when Schlosser and …

Fidelity Investments

Alignment Healthcare Lands $135 Million Investment To Grow Medicare Advantage | Forbes | 3/4/2020

Medicare Advantage plans to seniors this year and beyond. Alignment , which sells Medicare Advantage coverage in California and North Carolina doubled its California footprint this year by expanding into “eight greater Sacramento and Bay Area counties, where more than 862,000 Medicare recipients live,” the insurer said last fall. Now, Alignment says it has new investors with Wednesday’s announcement that a $135 million round of funding is coming from Fidelity Investments

Warburg Pincus

Alignment Healthcare just added another $135 million to its war chest as it plots growth in the red-hot Medicare Advantage market | 3/4/2020

… and services designed to help coordinate care, just raised another $135 million to expand its approach to the red-hot Medicare Advantage market. Alignment CEO John Kao told Business Insider that the company will be … has raised $375 million from investors like private-equity firms Warburg Pincus and General Atlantic. Alignment CEO John Kao told Business Insider that the company will use the fresh capital to expand into new markets …

T. Rowe Price

Alignment Healthcare just added another $135 million to its war chest as it plots growth in the red-hot Medicare Advantage market | Business Insider | 3/4/2020

… and services designed to help coordinate care, just raised another $135 million to expand its approach to the red-hot Medicare Advantage market. Alignment CEO John Kao told Business Insider that the company will be … it raised an additional $135 million from investors including Fidelity, T. Rowe Price, and Durable Capital Partners. In total, Alignment has raised $375 million from investors like private-equity firms Warburg Pincus and General Atlantic …

Stryker

Insights on the $34+ Billioin Cardiac Rhythm Management Devices Market Size, Share & Trends Analysis Report to 2027 | PR Newswire | 2/27/2020

… 2017, CVDs were responsible for about 800,000 lives lost in the U.S.Reimbursement policies, such as those introduced by the U.S. Medicare system, are among the major factors boosting the CRM market. Medical device companies now … market for cardiac rhythm management solutions are Physio-Control, Inc. (Stryker), Medtronic, St. Jude Medical, and Boston Scientific Corporation, which account for a significant share in the market owing to their extensive product offerings. Industry …

TPG Capital

Humana, private equity firm to launch senior primary-care centers | Modern Healthcare | 2/3/2020

… health insurer Humana has entered a joint venture with a private equity firm to develop more primary-care centers for Medicare Advantage patients. The Louisville, Ky.-based insurer expects the partnership to eventually more than … time, with the same private equity firm and another called TPG Capital. The trio also bought hospice operator Curo Health Services. According to the news announcement, Humana’s Partners in Primary Care will receive a management …

The Carlyle Group

FOTO, a Net Health Company, Receives Qualified Clinical Data Registry (QCDR) Designation from CMS | PR Newswire | 1/16/2020

… company, today announced that it has been approved as a 2020 Qualified Clinical Data Registry (QCDR) by the Centers for Medicare & Medicaid Services (CMS). This is the 11 th year that FOTO has achieved CMS … FOTO is owned by Net Health, a portfolio company of The Carlyle Group, Level Equity and Silversmith Capital Partners. Ben Lazar SVP Marketing [email protected] SOURCE Net Health Systems, Inc. Related Links nethealth.com …

Founders Fund

Oscar Health now has 400,000 members and expects to bring in $2 billion by the end of 2020 | TechCrunch | 1/14/2020

… 375,000 individual members on its insurance plans, with another 20,000 coming through small-group insurance and the balance derived from Medicare Advantage customers, according to a person familiar with the company’s business. Only three years … 2018 alone, Oscar raised $540 million from investors including Alphabet, Founders Fund, Capital G (Alphabet’s later-stage investment firm) and Verily, Alphabet’s investment firm focused on life sciences. In all, Oscar Health has raised $1.3 …

Venrock

Healthcare surprises for 2020 from top VC investors - Business Insider | 12/19/2019

… what they think would be the biggest surprises to hit healthcare in 2020. Those surprises could include some form of “Medicare for All” gaining traction, Amazon making a big healthcare deal, or Apple becoming a … venture investors think could rock 2020 was government action. For Venrock partner Bryan Roberts, having the government do something material in healthcare would be the biggest surprise. That could be anything on healthcare costs or …

Town Hall Ventures

Bright Health Riases $635M to Expand Medicare Advantage Plans to More Markets | HIT Consultant | 12/18/2019

… investments from Bessemer Venture Partners , Cross Creek Advisors , Declaration Partners , Flare Capital Partners , Greenspring Associates , Meritech Capital , Redpoint Ventures and Town Hall Ventures . With this round, Bright Health has raised over a billion dollars in … consumer-focused healthcare company offering Individual & Family health insurance and Medicare Advantage plans with more coverage for less money. Through their innovative healthcare product offerings, Bright Health is combining care and coverage to create affordability …

Redpoint Ventures

Amid Medicare Expansion, Bright Health Raises $635M | Forbes | 12/17/2019

Health insurer Bright Health said it has closed on a $635 million round of financing amid a major expansion of health plan products including Medicare Advantage to several new markets for 2020. The latest funding round was led by NEA and included investments from Bessemer Venture Partners, Cross Creek Advisors, Declaration Partners, Flare Capital Partners, Greenspring Associates, Meritech Capital, Redpoint Ventures and Town Hall Ventures. This brings to more than …

Piper Jaffray

Repealing insurance tax could help Medicare Advantage insurers | Modern Healthcare | 12/17/2019

… care insurers are reimbursed for the tax by the states they contract with. But in the fiercely competitive, fast-growing Medicare Advantage market, insurers have historically absorbed at least part of the tax to keep … Sarah James, a senior research analyst with financial services firm Piper Jaffray. About a third of Medicare beneficiaries, or 22 million people, are enrolled in Medicare Advantage plans. Many have been taking advantage of CMS …

Rock Health

ConsejoSano Named Top 50 In Digital Health For Most Devoted To Promoting Health Equity | PR Newswire | 12/11/2019

… that it has received the Top 50 In Digital Health honor for Most Devoted To Promoting Health Equity. Hosted by Rock Health, Fenwick & West, Goldman Sachs, and Pacific Western Bank, the annual accolade recognizes leading … care navigation solutions to payers, providers and health systems serving Medicare, Medicaid and underserved populations. It is currently the only healthcare engagement solution designed to address the needs of multicultural patients in the country. Company …

RA Capital Management

Wednesday, December 11, 2019 | Kaiser Health News | 12/11/2019

… day after the firm released him from a nondisclosure agreement. (Pager, 12/10) In other news from the elections — The Hill: ‘Medicare For All’ Backers Notch Win With High-Profile Hearing “Medicare for All” supporters scored … companies. A group of venture capitalists, including Peter Kolchinsky of RA Capital Management, Johannes Fruehauf of BioInnovation Capital and Sara Nayeem of New Enterprise Associates, met with Pelosi’s staff as well as moderate House and …

Harvard Medical School

‘Invisible Demon’: Virus Hits Even Top-Rated Nursing Homes | 5/21/2020

… away, the Kimberly Hall North nursing home in Windsor has the highest rating, five stars, issued by the Centers for Medicare & Medicaid Services. It has had one infection control citation, but no state or federal … nursing home data in 20 states led by researchers at Harvard Medical School. They found homes where residents were infected with the coronavirus tended to be larger than other facilities, in urban areas and in …

NYC Health

Northwell hospitals receive NY’s greatest share of federal hot spot funding | Crain’s New York Business | 5/18/2020

… data. The funding, announced May 1, aimed to allocate money to the hospitals that treated the most Covid-19 patients. NYC Health + Hospitals received the second-most funding, $699 million, and New York–Presbyterian qualified … billion was set aside for hospitals treating disproportionate shares of Medicare, Medicaid and uninsured patients. A previous round of $50 billion federal funding had calculated awards based on providers’ share of all U.S. Medicare payments …

Memorial Sloan Kettering Cancer Center

Northwell hospitals receive NY’s greatest share of federal hot spot funding | 5/18/2020

… Medicare, Medicaid and uninsured patients. A previous round of $50 billion federal funding had calculated awards based on providers’ share of all U.S. Medicare payments. That led to larger awards for some hospitals, such as Memorial Sloan Kettering Cancer Center, that treated fewer Covid-19 patients. MSK received the 20th-largest aid package nationwide in that earlier round, $64 million. The cancer hospital received $18 million in the latest hot …

Memorial Sloan Kettering

Northwell hospitals receive NY’s greatest share of federal hot spot funding | 5/18/2020

… Medicare, Medicaid and uninsured patients. A previous round of $50 billion federal funding had calculated awards based on providers’ share of all U.S. Medicare payments. That led to larger awards for some hospitals, such as Memorial Sloan Kettering Cancer Center, that treated fewer Covid-19 patients. MSK received the 20th-largest aid package nationwide in that earlier round, $64 million. The cancer hospital received $18 million in the latest hot …

Northwell Health

Northwell hospitals receive NY’s greatest share of federal hot spot funding | 5/18/2020

Reprints Print Northwell Health, the state’s largest private hospital system, received about $795 million in federal hot spot funding, which aimed to award facilities that took care of the most Covid-19 patients. Its award … billion was set aside for hospitals treating disproportionate shares of Medicare, Medicaid and uninsured patients. A previous round of $50 billion federal funding had calculated awards based on providers’ share of all U.S. Medicare payments …

Memorial Sloan Kettering Cancer Center, New York NY

Northwell hospitals receive NY’s greatest share of federal hot spot funding | 5/18/2020

… Medicare, Medicaid and uninsured patients. A previous round of $50 billion federal funding had calculated awards based on providers’ share of all U.S. Medicare payments. That led to larger awards for some hospitals, such as Memorial Sloan Kettering Cancer Center, that treated fewer Covid-19 patients. MSK received the 20th-largest aid package nationwide in that earlier round, $64 million. The cancer hospital received $18 million in the latest hot …

Cleveland Clinic, Cleveland OH

Some of biggest COVID payments go to providers who’ve paid large settlements | Modern Healthcare | 5/11/2020

… and the Indian Health Service. Of the companies documented to date, other top recipients ― including Dignity Health in Phoenix, the Cleveland Clinic , Houston’s Memorial Hermann Health System and Massachusetts General Hospital in Boston — have paid … civil accusations by DOJ that it submitted false claims to Medicare and TriCare, the military health care program. The Cleveland Clinic, which in 2015 paid $1.74 million to settle federal allegations that it mischarged Medicare

Massachusetts General Hospital

Some of biggest COVID payments go to providers who’ve paid large settlements | Modern Healthcare | 5/11/2020

… documented to date, other top recipients ― including Dignity Health in Phoenix, the Cleveland Clinic , Houston’s Memorial Hermann Health System and Massachusetts General Hospital in Boston — have paid millions in recent years to resolve allegations related … civil accusations by DOJ that it submitted false claims to Medicare and TriCare, the military health care program. The Cleveland Clinic, which in 2015 paid $1.74 million to settle federal allegations that it mischarged Medicare

Cleveland Clinic

Some of biggest COVID payments go to providers who’ve paid large settlements | Modern Healthcare | 5/11/2020

… and the Indian Health Service. Of the companies documented to date, other top recipients ― including Dignity Health in Phoenix, the Cleveland Clinic , Houston’s Memorial Hermann Health System and Massachusetts General Hospital in Boston — have paid … civil accusations by DOJ that it submitted false claims to Medicare and TriCare, the military health care program. The Cleveland Clinic, which in 2015 paid $1.74 million to settle federal allegations that it mischarged Medicare

Mercy Health

Leapfrog Group Awards Top Safety Grades to 13 Trinity Health Hospitals | PRWeb | 5/10/2020

… Center in Stafford Springs, Connecticut Loyola Gottlieb Memorial Hospital in Melrose Park, Illinois Loyola University Medical Center in Maywood, Illinois Mercy Health Hackley Campus in Muskegon, Michigan Mercy Health Saint Mary’s in Grand Rapids, Michigan … up to 28 national performance measures from the Centers for Medicare and Medicaid Services (CMS). Taken together, those performance measures produce a single letter grade representing a hospital’s overall performance in keeping patients safe from …

Kaiser Permanente

Wolters Kluwer Taps Marc ‘Frank’ Jackson to Lead ONC Interoperability & Payer Solutions at Health Language | Business Wire | 5/7/2020

… government policies, such as the recent interoperability rulings by the Office of the National Coordinator (ONC) and the Centers for Medicare and Medicaid Services (CMS), Jackson will drive strategic initiatives that leverage Health Language solutions … roles at Blue Cross Blue Shield of North Carolina and Kaiser Permanente along with other large payers. Jackson holds an MBA in finance from the University of Missouri—St. Louis, and a B.S. in computer …

Intermountain Healthcare

UPDATED Coronavirus tracker: Oscar, Uno partner on MA financial assistance; HHS awards more than $580M to expand testing | FierceHealthcare | 5/7/2020

UPDATED: Thursday, May 7 at 1:55 p.m. Oscar, Uno partner to offer financial assistance to Medicare Advantage members Oscar has teamed up with Uno Health to officer financial assistance to its Medicare Advantage members impacted … p.m. Intermountain starts limited COVID-19 antibody testing Utah-based Intermountain Healthcare has started using a COVID-19 antibody test offered to patients and caregivers that meet certain criteria. The test provided by ARUP Laboratories …

MD Anderson Cancer Center

Better Data Collection Key to Address EHR, Claims Data Discordance | 5/7/2020

Medicare Part D claims data for a rapidly growing cancer treatment. There is a moderate agreement between EHR data and Medicare Part D (MPD) claims data for the receipt of oral anticancer agents, which are a popular treatment option for cancer patients, according to a study published in JAMA Network Open . The study, conducted by the Texas Cancer Registry and The University of Texas MD Anderson Cancer Center (MDACC), found …

HCA

Here’s a look at just how much HCA, UHS and CHS took in CARES Act cash | 4/30/2020

Here’s a look at just how much HCA, UHS and CHS took in CARES Act cash by Tina Reed Apr 30, 2020 11:38am Three publicly-traded health systems, including HCA Healthcare, collectively took home more … also said they received more than $5.5 billion in accelerated Medicare payments. The CARES Act, passed last month, allocated $100 billion to cover related expenses for meeting COVID-19 outbreak and for recouping lost revenue …

HCA Healthcare

Here’s a look at just how much HCA, UHS and CHS took in CARES Act cash | FierceHealthcare | 4/30/2020

… and CHS took in CARES Act cash by Tina Reed Apr 30, 2020 11:38am Three publicly-traded health systems, including HCA Healthcare, collectively took home more than $1.1 billion in federal stimulus funds for woes … also said they received more than $5.5 billion in accelerated Medicare payments. The CARES Act, passed last month, allocated $100 billion to cover related expenses for meeting COVID-19 outbreak and for recouping lost revenue …

Community Health Systems

Here’s a look at just how much HCA, UHS and CHS took in CARES Act cash | 4/30/2020

Community Health Systems each told analysts how much in bailouts they took home from the feds. They also said they received more than $5.5 billion in accelerated Medicare payments. The CARES Act, passed last month, allocated $100 billion to cover related expenses for meeting COVID-19 outbreak and for recouping lost revenue. The Centers for Medicare and Medicaid Services also announced healthcare providers and suppliers could receive accelerated and advance …

Mayo Clinic

Medicare applications raise anxiety for seniors in pandemic - CBS News | 4/29/2020

Washington — At greater risk from COVID-19, some seniors now face added anxiety due to delays obtaining Medicare coverage. Advocates for older people say the main problem involves certain applications for Medicare’s “Part B” coverage … of mail-in voting Pence forgoes a face mask at Mayo Clinic Social Security handles eligibility determinations for Medicare, and while many issues can still be resolved online, some require personal attention. That can now …

UPMC

Live updates on COVID-19: March 16-31 | 4/24/2020

… billions of dollars to hospitals under the stimulus package signed by President Donald Trump last week. The department should direct Medicare Administrative Contractors “distribute funds to every hospital in the U.S. at the rate of … several new regulatory relief efforts aimed at easing hospital capacity. UPMC staff pay will not change through May 9 4:00 PM CT on 3/30/2020 UPMC said Monday it will ensure that all of its staff …

Oak Street Health

Newlight Partners Makes Substantial Contribution to Support Home-Bound Seniors During COVID-19 Pandemic | Business Wire | 4/24/2020

NEW YORK–(BUSINESS WIRE)–Apr 24, 2020–  Newlight Partners LP today announced it made a substantial contribution to the CPASS Foundation to provide 2,000 pulse oximeters and 4,600 digital thermometers to seniors in Illinois, Indiana, Michigan, North Carolina, Ohio, Pennsylvania, Rhode Island, and Tennessee. The CPASS Foundation is working in collaboration with Oak Street Health , a network of primary care centers delivering value-based care to adults on Medicare, and …

Boston Medical Center

Live updates on COVID-19: March 16-31 | Modern Healthcare | 4/24/2020

… billions of dollars to hospitals under the stimulus package signed by President Donald Trump last week. The department should direct Medicare Administrative Contractors “distribute funds to every hospital in the U.S. at the rate of … patients receive and foster better communication between providers and patients. Boston Medical Center Health System furloughs around 700 employees 4:05 PM CT on 3/31/2020 Boston Medical Center Health System has furloughed around 10% of its …

Henry Ford Health System

Live updates on COVID-19: March 16-31 | Modern Healthcare | 4/24/2020

… billions of dollars to hospitals under the stimulus package signed by President Donald Trump last week. The department should direct Medicare Administrative Contractors “distribute funds to every hospital in the U.S. at the rate of … seek vaccine trials in Michigan 10:02 PM CT on 03/27/2020 Henry Ford Health System, Ascension Michigan, Beaumont, Detroit Medical Center and Wayne State University are banding together to bring large-scale COVID-19 drug trials …

University of Rochester

Live updates on COVID-19: March 16-31 | 4/24/2020

… billions of dollars to hospitals under the stimulus package signed by President Donald Trump last week. The department should direct Medicare Administrative Contractors “distribute funds to every hospital in the U.S. at the rate of … and where?” Ann Marie Pettis, director of infection prevention for University of Rochester Medicine in upstate New York, and APIC 2020 president-elect, added that spread of PPE across the state has been inconsistent, saying …

Mount Sinai Health System

Live updates on COVID-19: March 16-31 | 4/24/2020

… billions of dollars to hospitals under the stimulus package signed by President Donald Trump last week. The department should direct Medicare Administrative Contractors “distribute funds to every hospital in the U.S. at the rate of … antibodies on critically-ill patients 8:34 AM CT on 3/29/2020 Mount Sinai Health System in New York will begin treating critically ill patients by transfering into them the antibodies from patients who have recovered from …

Sinai Health System

Live updates on COVID-19: March 16-31 | Modern Healthcare | 4/24/2020

… billions of dollars to hospitals under the stimulus package signed by President Donald Trump last week. The department should direct Medicare Administrative Contractors “distribute funds to every hospital in the U.S. at the rate of … on critically-ill patients 8:34 AM CT on 3/29/2020 Mount Sinai Health System in New York will begin treating critically ill patients by transfering into them the antibodies from patients who have recovered from COVID …

TriHealth

Live updates on COVID-19: March 16-31 | Modern Healthcare | 4/24/2020

… billions of dollars to hospitals under the stimulus package signed by President Donald Trump last week. The department should direct Medicare Administrative Contractors “distribute funds to every hospital in the U.S. at the rate of … care to patients in need of emergency surgery. Execs at TriHealth take a pay cut 8:42 PM CT on 3/26/2020 Cincinnati-based health system TriHealth’s senior leaders will take a 20% pay cut in light …

Humana

Humana, Healthmap team up on Florida kidney care coordination program | FierceHealthcare | 5/20/2020

Humana, Healthmap team up on Florida kidney care coordination program by May 20, 2020 9:00am Humana is launching a new kidney care program in Florida. (Humana) Humana is teaming up with Healthmap Solutions, a specialty population health management company, to offer a new care coordination program for Medicare Advantage and commercial members in Florida with kidney disease. Healthmap’s platform fills gaps in kidney care by streamlining communication between providers and …

Health Alliance Plan

HAP offers extended financial relief for members for the duration of 2020 in response to COVID-19 pandemic | PR Newswire | 5/20/2020

DETROIT , May 20, 2020 /PRNewswire/ – Health Alliance Plan (HAP), a Michigan -based nonprofit health plan, today announced several steps designed to provide financial relief and improve access to care for its members, including individual and Medicare Advantage members, as well as small business employers, all of whom have been impacted by the COVID-19 pandemic. HAP has extended its cost-sharing waiver for telehealth services through the end of the …

UnitedHealthcare

Study Finds Seniors with COVID-19 Taking Hypertension Medication at Lower Risk of Hospitalization, Clinical Trial to Follow Immediately | Business Wire | 5/19/2020

… peer-reviewed publication, analyzed retrospective data from about 10,000 patients testing positive for SARS-CoV-2 who were enrolled in Medicare Advantage or commercially insured plans, and had a prescription for one or more anti … broad spectrum of products and services through two distinct platforms: UnitedHealthcare, which provides health care coverage and benefits services; and Optum, which provides information and technology-enabled health services. For more information, visit UnitedHealth Group …

UCare

UCare discounts Medicare premiums with COVID-19 | Star Tribune | 5/19/2020

Purchase: Order Reprint UCare is discounting premiums for about 100,000 seniors in its Medicare Advantage health plans as people use less health care with COVID-19. The Minneapolis-based health plan said Tuesday it is discounting premiums by 20% for the months of July and August while eliminating copays for Medicare primary care and mental health clinic services during the COVID-19 public health emergency. Premium discounts at UCare also …

Indian Health Service

Some of biggest COVID payments go to providers who’ve paid large settlements | Modern Healthcare | 5/11/2020

… has also been steered to hot spots with high numbers of COVID-19 patients, rural health care providers and the Indian Health Service. Of the companies documented to date, other top recipients ― including Dignity Health … civil accusations by DOJ that it submitted false claims to Medicare and TriCare, the military health care program. The Cleveland Clinic, which in 2015 paid $1.74 million to settle federal allegations that it mischarged Medicare

Cigna

Cigna Takes Action To Protect Its Customers From COVID-19 Surprise Bills | 5/6/2020

BLOOMFIELD, Conn. , May 6, Cigna today is launching its new COVID-19 Customer Protection Program to further safeguard its customers from unexpected costs for COVID-19 care through “surprise” or “balance” bills from out-of … health plans, insured plans for U.S. based globally mobile individuals, Medicare Advantage and Individual and Family Plans (IFP). Cigna has also administered the protections to self-insured group health plans and the company encourages widespread …

Clover Health

Health-insurance startups like Oscar and Clover have raked in billions in venture funding. We dug into their financials, which show why 2020 stands to be a pivotal year for the insurers. | Business Insider | 5/5/2020

Bright Health cofounder Bob Sheehy, Devoted Health co-founder and executive chairman Todd Park, Clover Health CEO Vivek Garipalli, and Oscar Health CEO Mario Schlosser. Bright Health; Alex Wong/Getty; Clover Health; Oscar Health; Shayanne … Care Act’s markets and to seniors in the form of Medicare Advantage health plans. The financial results also provide some clues about where the insurance startups might expand over the coming years. To be sure …

Molina Healthcare

$820M Payer Acquisition Boosts Medicaid Portfolios Amid COVID-19 | 5/5/2020

Private Payers News $820M Payer Acquisition Boosts Medicaid Portfolios Amid COVID-19 Molina is using the deal to expand its Medicaid and Medicare portfolios as coronavirus drives Medicaid enrollment higher. 05, 2020 - Molina Healthcare, Inc. announced that it will acquire Magellan Complete Care from Magellan Health, Inc. on April 30, 2020. “We believe it will allow us to scale our enterprise-wide platforms and benefit from both operating and fixed …

Magellan Health

$820M Payer Acquisition Boosts Medicaid Portfolios Amid COVID-19 | HealthPayer Intelligence | 5/5/2020

Private Payers News $820M Payer Acquisition Boosts Medicaid Portfolios Amid COVID-19 Molina is using the deal to expand its Medicaid and Medicare portfolios as coronavirus drives Medicaid enrollment higher. 05, 2020 - Molina Healthcare, Inc. announced that it will acquire Magellan Complete Care from Magellan Health, Inc. on April 30, 2020. “We believe it will allow us to scale our enterprise-wide platforms and benefit from both operating and fixed …

Oscar Health

Health-insurance startups like Oscar and Clover have raked in billions in venture funding. We dug into their financials, which show why 2020 stands to be a pivotal year for the insurers. | Business Insider | 5/5/2020

… Bright Health cofounder Bob Sheehy, Devoted Health co-founder and executive chairman Todd Park, Clover Health CEO Vivek Garipalli, and Oscar Health CEO Mario Schlosser. Bright Health; Alex Wong/Getty; Clover Health; Oscar Health; Shayanne … Care Act’s markets and to seniors in the form of Medicare Advantage health plans. The financial results also provide some clues about where the insurance startups might expand over the coming years. To be sure …

Bright Health

Health-insurance startups like Oscar and Clover have raked in billions in venture funding. We dug into their financials, which show why 2020 stands to be a pivotal year for the insurers. | Business Insider | 5/5/2020

Bright Health cofounder Bob Sheehy, Devoted Health co-founder and executive chairman Todd Park, Clover Health CEO Vivek Garipalli, and Oscar Health CEO Mario Schlosser. Bright Health; Alex Wong/Getty; Clover Health; Oscar Health; Shayanne … Care Act’s markets and to seniors in the form of Medicare Advantage health plans. The financial results also provide some clues about where the insurance startups might expand over the coming years. To be sure …

Health Net

Centene To Invest In Critical Mental Health Resources | 5/4/2020

… For many, the emotional trauma of COVID-19 will last longer than the pandemic itself. Centene is partnering with Allegheny Health Network and the CARES Institute at Rowan University to fund 25 virtual Trauma-Focused … 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace, the TRICARE program, and individuals in …

Sunshine Health

Critical Needs Fund Supports Children and Young Adults in Foster Care | PR Newswire | 5/4/2020

Critical Needs Fund Supports Children and Young Adults in Foster Care Sunshine Health/CBCIH award $220,000 to lessen COVID-19 impact on children News provided by May 04, 2020, 08:00 ET Share this article SUNRISE … Medicaid, Long Term Care, the Health Insurance Marketplace (Ambetter) and Medicare (Allwell). Sunshine Health is now affiliated with WellCare Health Plan’s Florida health plans, including Staywell Health Plan and WellCare of Florida Medicare Advantage and …

Centene Corp

Meridian Supports Illinois Communities in Need During the COVID-19 Pandemic | PR Newswire | 5/4/2020

… challenges include basic daily needs such as access to food and essential healthcare and educational supplies. Meridian, a subsidiary of Centene Corporation, a leading multi-national healthcare company, is deploying these programs across the state … and individuals with complex medical needs primarily through Medicaid (MeridianHealth), Medicare Advantage (WellCare), Medicare-Medicaid Alignment Initiative (MeridianComplete) and Medicare Prescription Drug Plans (WellCare) across the state. Meridian and WellCare are wholly owned subsidiaries of …

Aetna

Why primary care needs a prospective payment system | 5/2/2020

… Aetna, Medicare Advantage, Medicare shared savings. Since we (have all of those) lives under contract, the physician practices can have a single model to take care of all their patients. Unfortunately, the way value-based care is rolled out, and why it’s been so slow, is that practices have had to segregate populations with a certain management company over here, and then another value-based opportunity over there. That kind …

Senior Whole Health

Magellan Health and Molina Healthcare Enter Into Definitive Agreements to Divest Magellan Complete Care and Establish Commercial Relationship for Multiple Magellan Services | Business Wire | 4/30/2020

Medicare health plans including Magellan Complete Care in Arizona, Florida and Virginia; Senior Whole Health in Massachusetts and New York; and TMG by Magellan in Wisconsin. “The novel coronavirus pandemic has served to highlight that the behavioral health needs of states, health plans and individuals remain a critical societal need. In addition, Magellan’s payer partners are having limited success in managing high cost populations, notably in fully integrating behavioral and …

Amerigroup

Health Partners Plans Names Kevin Clancy as Chief Financial Officer | Business Wire | 4/29/2020

… Wire) Clancy brings more than 37 years of financial leadership at managed care organizations across the country, including commercial, Medicaid, Medicare and CHIP health care plans. As CFO, Clancy will be responsible for financial plans … FamilyCare, Clancy served as the vice president, finance for Anthem/Amerigroup in Houston, Texas. “HPP’s commitment to finding new ways to encourage better health outcomes for its members is inspiring and I’m pleased to be …

SCAN Health Plan

Medicare Advantage insurers tested by flood of kidney failure patients | Modern Healthcare | 4/27/2020

Print DaVita Kidney Care A DaVita Kidney Care clinician tends to a dialysis patient. Medicare spending on kidney disease totaled more than $114 billion in 2016. A corner of the health insurance industry that has … said Jill Selby, a corporate vice president at California-based SCAN Health Plan, which has offered a Medicare Advantage special needs plan for ESRD patients since 2006. People with permanent kidney failure, including those under …

Priority Health

Medicare Advantage insurers tested by flood of kidney failure patients | Modern Healthcare | 4/27/2020

Print DaVita Kidney Care A DaVita Kidney Care clinician tends to a dialysis patient. Medicare spending on kidney disease totaled more than $114 billion in 2016. A corner of the health insurance industry that has … based care arrangements to drive better health outcomes. Michigan-based Priority Health is training its care managers to be able to better serve patients with ESRD. Humana is expanding its ability to facilitate dialysis at …

Tufts Health Plan

$5.1M Grant Addresses Social Determinants of Health in Seniors | HealthPayer Intelligence | 4/20/2020

… to senior members struggling during the coronavirus. Source: Getty Images By April 20, 2020 - SCAN Health Plan, a California-based Medicare Advantage group, is committing $5.1 million in funding to help seniors mitigate some of … social determinants of health during the coronavirus outbreak. In March, Tufts Health Plan and Humana both committed funding to help enable access to health and nutritious meals. The $1 million grant from Tufts Health Plan

Primecare

Solis Health Plans and PrimeCare Family Medical Centers to Hold Contactless Drive-Thru Food Drive | PR Newswire | 4/16/2020

… are struggling to obtain basic necessities to help get them through the coronavirus (COVID-19) pandemic. Solis Health Plans and PrimeCare Family Medical Centers , in partnership with organizers Commissioner Esteban “Steve” Bovo Jr ., Mayor of … Health Plans Solis Health Plans is a community-focused Florida Medicare Advantage health plan that delivers outstanding member experience and exceptional service to its members, providers, and brokers and offers competitive plans with expanded benefits …

UPMC Health Plan

New “Work-From-Home” Telecommunication And Enrollment Technologies Enable Medicare Insurers’ Response To Virus | PR Newswire | 4/15/2020

PITTSBURGH , April 15, Currently more than one third of the Medicare population enrolls in a Medicare Advantage (MA) plan, and the first point of contact between eligible individuals and health plans is typically with a … many of America’s top insurers, including several BlueCross/ BlueShield companies, UPMC Health Plan, Johns Hopkins Healthcare, Lumeris and United Healthcare. For details visit: www.cavulus.com . Media Inquiries: 800-760-6915 Email: Cavulus Related Links http://www.cavulus.com …

Wellcare

‘Ohana Health Plan Donates 26,000 Units of PPE to Hawaii Health Care Workers amid COVID-19 Pandemic | 4/10/2020

… www.wellcare.com/en/Hawaii/COVID-19 . About ‘Ohana Health Plan ‘Ohana Health Plan provides government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans (WellCare) to approximately 48,000 members across the state. ‘Ohana Health Plan is a wholly owned subsidiary of Centene Corporation, a leading multi-national healthcare enterprise committed to helping people live healthier lives …

Coventry Health Care

Industry Voices—A path forward for successfully managing risk adjustment, care quality amid COVID-19 | 4/10/2020

… keeping populations healthy—aren’t happening for millions of Americans. This has a disproportional impact on the most vulnerable populations—especially Medicare beneficiaries. Delaying care is not only bad for seniors who cannot receive the treatment … senior executive positions at Humana, and served as SVP at Coventry Health Care for over 1.5 million members across 11 states …

Fidelis Care

Fidelis Care Expands Access to Telehealth Services to Support Members During COVID-19 Emergency | PR Newswire | 4/9/2020

NEW YORK To support members and the health of local communities during the COVID-19 outbreak, Fidelis Care has expanded access to telehealth services, covering virtual visits with providers from the safety, comfort, and convenience … Child Health Plus, Essential Plan, Health and Recovery Plan (HARP), Medicare Advantage, and Dual Advantage members. Through Teladoc, members can access online care by phone or video, from board-certified, NY State-licensed doctors, 24 …

Ron Wyden

Watchdog cites persistent infection lapses in nursing homes | 5/20/2020

Ron Wyden of Oregon, the top Democrat on a committee that oversees Medicare and Medicaid. “There need to be big changes in the way nursing homes care for seniors.” The report from the Government Accountability Office found that state inspectors who help enforce federal nursing home standards classified the overwhelming majority of violations as not severe, generally meaning there was no actual harm to residents. The federal Centers for Medicare

George W. Bush

‘We need a comprehensive battle strategy’: States opening their economies lack benchmarks for reimposing restrictions - The Washington Post | 5/15/2020

Medicare and Medicaid Services under President George W. Bush, said state leaders know “they may need to pause or even step back.” AD Sign up for our Coronavirus Updates newsletter to track the outbreak. All stories linked in the newsletter are free to access. “But we haven’t seen a whole lot of detail on those specific plans in most states,” said McClellan, a member of the advisory group assisting Texas …

Mark McClellan

‘We need a comprehensive battle strategy’: States opening their economies lack benchmarks for reimposing restrictions - The Washington Post | 5/15/2020

… Mark McClellan, a former commissioner of the Food and Drug Administration and administrator of the Centers for Medicare and Medicaid Services under President George W. Bush, said state leaders know “they may need to pause or even step back.” AD Sign up for our Coronavirus Updates newsletter to track the outbreak. All stories linked in the newsletter are free to access. “But we haven’t seen a whole lot of detail …

Robert King

Providers press CMS to extend deadline on whether an ACO can quit to Oct. 31 | 5/14/2020

Providers press CMS to extend deadline on whether an ACO can quit to Oct. 31 by Robert King May 14, 2020 4:05pm Provider groups say accountable care organizations should be given an option on how to handle repaying losses to Medicare for not meeting spending targets. (Getty/Ca-ssis) Provider groups say accountable care organizations (ACOs) need until Oct. 31 to decide whether to leave the Medicare Shared Savings Program …

Michael Neidorff

Centene To Invest In New Technology, Supplies To Improve Access To Quality Healthcare For Incarcerated Population | 5/13/2020

… to protect and advocate for the most vulnerable populations, and incarcerated individuals have some of the greatest healthcare needs,” said Michael Neidorff , Chairman, President and CEO of Centene. “Today we are doubling down on our … 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace, the TRICARE program, and individuals in …

Seema Verma

CMS Proposes to Increase Inpatient Medicare Reimbursement by 1.6% | 5/12/2020

Policy & Regulation News CMS Proposes to Increase Inpatient Medicare Reimbursement by 1.6% The proposed rule would also create a new inpatient Medicare reimbursement category for CAR T-cell therapy and a new tech add-on … their business and receive stable and consistent payment,” CMS Administrator Seema Verma said in the proposed rule’s announcement . In the announcement, Administrator Verma also released proposed updates to the Long-Term Care Hospital (LTCH) Prospective …

Laura Wood

The World Market for Surgical Masks (2015-2025): Unprecedented Demand for N-95 Masks due to the Outbreak of COVID-19 | 5/12/2020

… the Global Surgical Masks Market include The 3M Company, Cartel Healthcare, Thea-Tex Healthcare ( India ) Pvt. Ltd., Z Plus Disposable, Medicare Hygiene Limited, Mediblue Health Care Private Limited, Medline Industries Inc., Plasti Surge Industries Pvt … focused, comprehensive and tailored research. Media Contact: Research and Markets Laura Wood , Senior Manager [email protected] For E.S.T Office Hours Call +1-917-300-0470 For U.S./CAN Toll Free Call +1-800-526-8630 For GMT Office Hours Call +353-1-416-8900 …

Donald Trump

Some of biggest COVID payments go to providers who’ve paid large settlements | 5/11/2020

… the coming days as other companies confirm they’ve received money. In total, the CARES Act, signed into law by President Donald Trump in March, provides $100 billion in emergency funding. Subsequent coronavirus relief legislation added … civil accusations by DOJ that it submitted false claims to Medicare and TriCare, the military health care program. The Cleveland Clinic, which in 2015 paid $1.74 million to settle federal allegations that it mischarged Medicare

Andy Slavitt

How Is The Federal Government Doing At Guiding A Smart Reopening? : NPR | 5/11/2020

NPR’s Steve Inskeep talks to Dr. Scott Gottlieb, former head of the Food and Drug Administration, and Andy Slavitt, who led the Centers for Medicare and Medicaid Services, about reopening the country. STEVE INSKEEP, HOST: Like it or not, the U.S. economy is shaking out of its many weeks on pause. Several states have lifted stay-at-home orders. Factories are reopening from Michigan to Washington state. Cellphone data show …

Scott Gottlieb

How Is The Federal Government Doing At Guiding A Smart Reopening? : NPR | 5/11/2020

NPR’s Steve Inskeep talks to Dr. Scott Gottlieb, former head of the Food and Drug Administration, and Andy Slavitt, who led the Centers for Medicare and Medicaid Services, about reopening the country. STEVE INSKEEP, HOST: Like it or not, the U.S. economy is shaking out of its many weeks on pause. Several states have lifted stay-at-home orders. Factories are reopening from Michigan to Washington state. Cellphone data show …

Alex Azar

340B hospitals say it’s a bad time to collect drug costs info | 5/7/2020

… hospitals to submit their drug acquisition costs by May 15. It could use the information to determine reimbursement rates for Medicare Part B drugs. But providers’ reluctance to share information with the federal government about … more difficult for providers to qualify for discounts. HHS Secretary Alex Azar was formerly president of drugmaker Eli Lilly and Company and a pharmaceutical lobbyist. Letter Editor Send us a letter Have an opinion about …

Bruce Broussard

Coronavirus has sped up telehealth, made care more convenient, Humana CEO says | 5/6/2020

Bruce Broussard said will have a lasting impact on care delivery. Mr. Broussard told CNBC ‘s “Closing Bell” on May 5 that the rise of telemedicine during the pandemic has opened healthcare up to more convenient settings. In response, Humana announced that it will waive all cost-sharing for in-network telehealth visits for its 4.5 million Medicare Advantage members through the end of the year. “The virus is giving …

Javier Rodriguez

DaVita Inc. COVID-19 Response Efforts and 1st Quarter 2020 Results | 5/6/2020

Medicare and Medicaid Services, Centers for Disease Control and Prevention, and dialysis providers nationwide to help ensure that the dialysis community is able to support dialysis patients nationwide. “I am proud and humbled by the amazing efforts of our 65,000 teammates around the world,” said Javier Rodriguez , CEO of DaVita Inc., “I offer my deepest gratitude to them all, especially to our caregiving teammates and physician partners working heroically to …

Vivek Garipalli

Health-insurance startups like Oscar and Clover have raked in billions in venture funding. We dug into their financials, which show why 2020 stands to be a pivotal year for the insurers. | Business Insider | 5/5/2020

Bright Health cofounder Bob Sheehy, Devoted Health co-founder and executive chairman Todd Park, Clover Health CEO Vivek Garipalli, and Oscar Health CEO Mario Schlosser. Bright Health; Alex Wong/Getty; Clover Health; Oscar Health; Shayanne … Care Act’s markets and to seniors in the form of Medicare Advantage health plans. The financial results also provide some clues about where the insurance startups might expand over the coming years. To be sure …

Adam Boehler

A volunteer on Kushner’s coronavirus team filed a complaint to Congress warning the group was ‘falling short’ on helping health care workers | 5/5/2020

Kushner, the president’s son-in-law, has tapped volunteers from consulting and private equity firms to help his response team. The team also works with private industry executives and government officials, the Post reported, including Brad Smith, director of the Centers for Medicare and Medicaid Innovation, and Adam Boehler, a former Health and Human Services official who was asked to help the coronavirus response. Loading Something is loading. But lack …

Dean Kamen

Live updates on COVID-19: April 1-15 | 5/5/2020

… protective equipment at the Manchester-Boston Regional Airport. The Republican governor was joined by Democratic U.S. Sen. Jeanne Shaheen and Dean Kamen, who helped spearhead the effort. The cargo plane departed Shanghai, China, on Saturday … Act would be distributed based on providers’ share of nationwide Medicare payments. The New York delegation highlighted that their state has seen the highest number of cases and deaths from COVID-19 nationwide. “Our hospitals …

Alex Wong

Health-insurance startups like Oscar and Clover have raked in billions in venture funding. We dug into their financials, which show why 2020 stands to be a pivotal year for the insurers. | Business Insider | 5/5/2020

… co-founder and executive chairman Todd Park, Clover Health CEO Vivek Garipalli, and Oscar Health CEO Mario Schlosser. Bright Health; Alex Wong/Getty; Clover Health; Oscar Health; Shayanne Gal/Business Insider This story is available … Care Act’s markets and to seniors in the form of Medicare Advantage health plans. The financial results also provide some clues about where the insurance startups might expand over the coming years. To be sure …

Joe Biden

Biden’s top potential running mates bring unique strengths — and weaknesses | Yahoo News | 5/4/2020

WASHINGTON — Joe Biden’s selection of a running mate matters more than any other VP pick we can remember — because of Biden’s age, because of the coronavirus, and because it could eventually produce the nation’s first … either on her issue positions (she isn’t a backer of Medicare for All, for example) or her past controversies (like delinquent taxes). Catherine Cortez Masto (U.S. senator, Nevada) Strengths: As a Latina, she’d add a …

Kamala Harris

Biden’s top potential running mates bring unique strengths — and weaknesses | 5/4/2020

… run for president in 2020, Abrams hasn’t been vetted nationally – either on her issue positions (she isn’t a backer of Medicare for All, for example) or her past controversies (like delinquent taxes). Catherine Cortez Masto … her as his vice president could set that effort back. Kamala Harris (U.S. senator, California) Strengths: Like Stacey Abrams, Harris has the potential to excite African-American voters and fulfill the request by Democrats like …

Amy Klobuchar

Biden’s top potential running mates bring unique strengths — and weaknesses | 5/4/2020

… run for president in 2020, Abrams hasn’t been vetted nationally – either on her issue positions (she isn’t a backer of Medicare for All, for example) or her past controversies (like delinquent taxes). Catherine Cortez Masto … her time as a prosecutor and as California’s attorney general. Amy Klobuchar (U.S. senator, Minnesota) Strengths: Hailing from the Midwest, she would give a Biden ticket geographical diversity. Klobuchar has been a proven winner in …

Michael F. Neidorff

Centene To Invest In Critical Mental Health Resources | 5/4/2020

… the negative toll that the pandemic is taking on the mental health of our communities – especially among underserved communities,” said Michael F. Neidorff , Chairman, President and CEO of Centene. “We will continue to support these … 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace, the TRICARE program, and individuals in …

Hillary Clinton

Trump vs. Biden is the 2020 election nightmare women like me warned America about | 5/2/2020

… respect for science we need to save lives and revive the economy. Join us today: https://t.co/mxkpLIOEux pic.twitter.com/9TE9Lw9XBw — Hillary Clinton (@HillaryClinton) April 28, 2020 This week, Clinton formally endorsed former Vice President Joe … 56,000 who have died, deserved a candidate who advocated for “Medicare for All,” not someone who believes their access to health insurance should remain tethered to their employment . The Americans who cite medical costs in …

Matthew Weinstock

Why primary care needs a prospective payment system | Modern Healthcare | 5/2/2020

… 19 outbreak has exacerbated cracks in the fee-for-service model, he said. Crow spoke with Modern Healthcare Managing Editor Matthew Weinstock. The following is an edited transcript. MH: The expansion you started last year … work with) Blue Cross and Blue Shield, UnitedHealthcare, Cigna, Aetna, Medicare Advantage, Medicare shared savings. Since we (have all of those) lives under contract, the physician practices can have a single model to take care …

Tina Reed

Here’s a look at just how much HCA, UHS and CHS took in CARES Act cash | 4/30/2020

Here’s a look at just how much HCA, UHS and CHS took in CARES Act cash by Tina Reed Apr 30, 2020 11:38am Three publicly-traded health systems, including HCA Healthcare, collectively took home more … also said they received more than $5.5 billion in accelerated Medicare payments. The CARES Act, passed last month, allocated $100 billion to cover related expenses for meeting COVID-19 outbreak and for recouping lost revenue …

Bill Clinton

How a Los Angeles doctor got swept up in the swirl of the Trump White House as it confronts the pandemic | STAT | 4/29/2020

… Dipasupil/Getty Images, Alex Hogan/STAT H e advised Joe Biden’s initiative to transform the fight against cancer. He interviewed Bill Clinton at last fall’s “Time 100” gala. And he’s treated patients with names so … Services and from agencies including the FDA, the Centers for Medicare and Medicaid Services, and the Centers for Disease Control and Prevention. By and large, Agus has talked with officials about the Oracle database. But …