Health Care Compliance Brief

ACOs led by independent physicians save Medicare ‘substantially’ more money, CBO says

Healthcare Dive

APRIL 17, 2024

Independent practices have clearer financial incentives to lower medical spending than hospitals participating in accountable care organizations, according to the Congressional Budget Office.

Medicare

Medicare Medicare Hospitals

Envision Healthcare names permanent CEO

Healthcare Dive

APRIL 17, 2024

Jason Owen took on the leadership role this week, months after the physician staffing firm emerged from bankruptcy restructuring.

Steward bankruptcy likely as massive debt remains, with few options left

Healthcare Dive

APRIL 16, 2024

Steward Health Care’s forbearance period ends in less than 15 days. Analysts say this time, creditors are unlikely to extend the embattled company another lifeline.

New federal health IT strategy increases focus on public health, AI

Healthcare Dive

MARCH 28, 2024

The draft plan builds on its predecessor, which the health IT agency said drove “significant progress” in the use and exchange of electronic health information.

Public Health

Healthcare companies expand perks to recruit talent: report

Healthcare Dive

MARCH 27, 2024

The increase stands in contrast to other industries, which have cut back on extra offerings year over year.

Senior lawmaker questions UnitedHealth over Change cyberattack

Healthcare Dive

MARCH 26, 2024

Rep. Jamie Raskin, D-Md., said UnitedHealth’s “rapid consolidation and vertical integration” has major consequences for the healthcare sector, including increased control of the health IT market.

Ascension will outsource Illinois hospitalist functions to PE-backed staffing firm

Healthcare Dive

MARCH 26, 2024

Beginning June 1, the Catholic health system will cede responsibility of hospitalist functions to staffing firm SCP Health.

Tax breaks exceed community care spending at large majority of nonprofit hospitals: report

Healthcare Dive

MARCH 26, 2024

Nonprofits’ cumulative “fair share” deficit is enough to pay off the medical debt of everyone in California, Texas, New York and Pennsylvania combined, according to the Lown Institute.

Hospitals

Google launches AI-backed search-and-answer tool for doctors

Healthcare Dive

MARCH 12, 2024

Vertex AI Search for Healthcare comes as the industry awaits a regulatory structure from the federal government around the use of AI in healthcare.

Doctors

Doctors Governance

For-profit hospital operators bet on outpatient services, expense reductions in 2023

Healthcare Dive

MARCH 12, 2024

While HCA Healthcare, Tenet Healthcare and Universal Health Services posted net gains by the end of the year, Community Health Systems reported losses.

Hospitals

Cerner’s shift to cloud cuts costs, improves cybersecurity, Oracle says

Healthcare Dive

MARCH 12, 2024

Oracle will also begin delivering a new ambulatory clinic suite in its fourth quarter, which includes an AI-backed documentation assistant.

Microsoft forms health AI governance network

Healthcare Dive

MARCH 12, 2024

The tech giant is standing up the group with 16 health systems, two healthcare technology companies and zero AI development rivals.

Governance

Elevance completes Paragon Health acquisition

Healthcare Dive

MARCH 11, 2024

The infusion services and drug therapy company will operate under CarelonRx, Elevance’s pharmacy benefit manager.

Small, financially struggling providers at risk from Change cyberattack: Moody’s

Healthcare Dive

MARCH 11, 2024

Larger providers, however, aren’t immune from cash flow challenges, especially if UnitedHealth Group is unable to restore systems by mid-March.

Federal government probes healthcare private equity deals

Healthcare Dive

MARCH 6, 2024

The cross-agency investigation comes as scrutiny rises regarding corporate consolidation in healthcare.

Governance

Dexcom receives FDA clearance for first OTC glucose sensor

Healthcare Dive

MARCH 6, 2024

The diabetes tech firm tailored its software to the 25 million people in the U.S. who have Type 2 diabetes and do not use insulin.

FDA

Walgreens’ VillageMD to exit Illinois

Healthcare Dive

MARCH 1, 2024

The primary care chain plans to shutter its remaining clinics in the state by April 19 as Walgreens continues to cut costs.

Molina loses Medicaid contract in Virginia

Healthcare Dive

MARCH 1, 2024

It’s the second recent Medicaid state loss for Molina, despite executives expressing confidence about the insurer’s ability to retain contracts.

Medicaid

Medicaid Medicaid

Cleveland Clinic posts $911M net gain in 2023 on investment, volume growth

Healthcare Dive

MARCH 1, 2024

The health system is the latest to report a financial turnaround compared to 2022, which analysts called the worst operational year on record for nonprofit hospitals.

Hospitals

Change Healthcare cyberattack having ‘far-reaching’ effects on providers

Healthcare Dive

MARCH 1, 2024

Providers said the outage at the UnitedHealth-owned technology company has affected billing, eligibility checks, prior authorization requests and prescription fulfillment.

Trinity Health cuts operating losses by 85% in first half of 2024

Healthcare Dive

FEBRUARY 26, 2024

Revenue from acquisitions and outpatient services helped the Catholic health system trim losses.

R1 RCM receives takeover offer from New Mountain

Healthcare Dive

FEBRUARY 26, 2024

The private equity firm’s offer represents a 24% premium to R1’s closing price on Friday, but could be undervaluing the company, analysts said.

False claims settlements in healthcare reached $1.8B in fiscal year 2023

Healthcare Dive

FEBRUARY 26, 2024

According to the Department of Justice, enforcement in Medicare Advantage is of “critical importance” as the number of beneficiaries in the privatized insurance program swells.

Medicare

Medicare Medicare

CMS finalizes rule to cut Medicaid DSH payments for some hospitals

Healthcare Dive

FEBRUARY 21, 2024

Under the new definition, hospitals can only receive disproportionate share hospital Medicaid reimbursements for beneficiaries who are primarily insured by the safety-net program.

Medicaid

Medicaid Medicaid Hospitals

Medicare Advantage plans provide less intensive post-acute care, study finds

Healthcare Dive

FEBRUARY 21, 2024

The research found no differences in 30-day hospital readmissions or mortality, but the study’s authors said more analysis on patients’ long-term functioning was needed.

Medicare

Medicare Medicare Hospitals

Teladoc still looking for tech investments, M&A amid operational review

Healthcare Dive

FEBRUARY 21, 2024

The telehealth vendor is trimming expenses, but it could pursue deals with strategically or financially attractive companies.

Disputes over surprise billing continue to soar, new CMS data shows

Healthcare Dive

FEBRUARY 16, 2024

Arbiters are mostly selecting the higher payment offer in billing dispute determinations. That suggests No Surprises could actually raise premiums for consumers, one health researcher said.

House subcommittee grills VA, Oracle over pharmacy issues amid EHR rollout

Healthcare Dive

FEBRUARY 15, 2024

Rollout of the new electronic health record has been rocky, with system reliability and safety concerns plaguing the Department of Veterans Affairs.

Department of Veterans Affairs

CommonSpirit trims operating losses in second quarter

Healthcare Dive

FEBRUARY 16, 2024

The nonprofit posted improved net income, but rising expenses continued to vex the system.

Telehealth services during pandemic largely compliant with Medicare, OIG finds

Healthcare Dive

FEBRUARY 16, 2024

The latest audit from HHS’ Office of Inspector General comes as some Medicare flexibilities for telehealth are set to expire at the end of this year.

Medicare

Medicare Medicare

Amazon cuts hundreds of One Medical, Amazon Pharmacy jobs

Healthcare Dive

FEBRUARY 7, 2024

The layoffs come after the CEO praised the divisions’ “momentum” on a fourth-quarter earnings call.

AHA calls for more payer oversight in No Surprises dispute resolution

Healthcare Dive

FEBRUARY 7, 2024

In comments on a proposed rule, the American Hospital Association argued regulators haven’t fully addressed how they’ll handle oversight for some situations, like when an insurer fails to pay after a dispute determination.

Hospitals

CVS cuts 2024 outlook on Medicare Advantage caution

Healthcare Dive

FEBRUARY 7, 2024

The insurer on Wednesday joined its peers in slamming proposed MA payment rates as insufficient given the dogged increase in medical costs.

Medicare

Medicare Medicare

Chicago children’s hospital network still offline following ‘cybersecurity matter’

Healthcare Dive

FEBRUARY 7, 2024

Lurie Children’s Hospital first reported the outage last week. Phone, email and electronic systems are still down.

Hospitals

HHS settles cybersecurity investigation with Montefiore Medical Center

Healthcare Dive

FEBRUARY 7, 2024

The nonprofit will pay $4.75 million to settle allegations that data security failures allowed an employee to steal and sell the protected health information of thousands of patients, according to the HHS.

Telehealth availability for mental healthcare varies by state, study finds

Healthcare Dive

FEBRUARY 1, 2024

Mental health treatment can be challenging to access, and earlier research has found telehealth could expand the number of people who receive care. But the latest study found virtual care availability could be hindered by location.

Walgreens lays off another 145 employees

Healthcare Dive

FEBRUARY 2, 2024

The drugstore retailer said it still has “significant cost savings and growth goals to deliver” as it confirmed further downsizing of its workforce.

HHS finalizes rule on telehealth at opioid treatment programs

Healthcare Dive

FEBRUARY 2, 2024

Programs could begin some medication treatment via telehealth under the rule, which the agency argues will remove transportation barriers and expand access to care.

Providence erases or refunds $158M in medical bills

Healthcare Dive

FEBRUARY 2, 2024

The Renton, Washington-based nonprofit health system will refund millions to settle allegations it skirted charity care obligations between 2018 and 2023.

Medical Billing

Nurse sues UPMC over alleged labor abuses

Healthcare Dive

JANUARY 23, 2024

The lawsuit seeks to represent thousands of other UPMC employees who may have been affected by the nonprofit’s alleged wage suppression and other anticompetitive practices.

Nurses

Centene wins New Hampshire Medicaid contract

Healthcare Dive

JANUARY 19, 2024

It’s not yet clear how much the new Medicaid managed care contract is worth. The state’s previous contract with insurers, including Centene, allocated $6 billion in funds over five years.

Medicaid

Medicaid Medicaid

Allina Health CFO to depart

Healthcare Dive

JANUARY 19, 2024

The Minneapolis-based nonprofit will launch a nationwide search for a successor to Ric Magnuson, who has served Allina for over 25 years.

Financial distress drove nearly a third of hospital M&A in 2023: Kaufman Hall

Healthcare Dive

JANUARY 19, 2024

Mergers and acquisitions increased last year as health systems sought strong partners while expanding capabilities in “core” markets, the consultancy said.

Hospitals

Nuance’s AI clinical scribe integrated with Epic is now generally available

Healthcare Dive

JANUARY 19, 2024

More than 150 health systems, hospitals and medical centers will deploy the Dragon Ambient eXperience Copilot embedded within Epic, the Microsoft-owned company said.

Hospitals

Healthcare Dive

ACOs led by independent physicians save Medicare ‘substantially’ more money, CBO says

Envision Healthcare names permanent CEO

Trending Sources

Steward bankruptcy likely as massive debt remains, with few options left

New federal health IT strategy increases focus on public health, AI

Healthcare companies expand perks to recruit talent: report

Senior lawmaker questions UnitedHealth over Change cyberattack

Ascension will outsource Illinois hospitalist functions to PE-backed staffing firm

Tax breaks exceed community care spending at large majority of nonprofit hospitals: report

Google launches AI-backed search-and-answer tool for doctors

For-profit hospital operators bet on outpatient services, expense reductions in 2023

Cerner’s shift to cloud cuts costs, improves cybersecurity, Oracle says

Microsoft forms health AI governance network

Elevance completes Paragon Health acquisition

Small, financially struggling providers at risk from Change cyberattack: Moody’s

Federal government probes healthcare private equity deals

Dexcom receives FDA clearance for first OTC glucose sensor

Walgreens’ VillageMD to exit Illinois

Molina loses Medicaid contract in Virginia

Cleveland Clinic posts $911M net gain in 2023 on investment, volume growth

Change Healthcare cyberattack having ‘far-reaching’ effects on providers

Trinity Health cuts operating losses by 85% in first half of 2024

R1 RCM receives takeover offer from New Mountain

False claims settlements in healthcare reached $1.8B in fiscal year 2023

CMS finalizes rule to cut Medicaid DSH payments for some hospitals

Medicare Advantage plans provide less intensive post-acute care, study finds

Teladoc still looking for tech investments, M&A amid operational review

Disputes over surprise billing continue to soar, new CMS data shows

House subcommittee grills VA, Oracle over pharmacy issues amid EHR rollout

CommonSpirit trims operating losses in second quarter

Telehealth services during pandemic largely compliant with Medicare, OIG finds

Amazon cuts hundreds of One Medical, Amazon Pharmacy jobs

AHA calls for more payer oversight in No Surprises dispute resolution

CVS cuts 2024 outlook on Medicare Advantage caution

Chicago children’s hospital network still offline following ‘cybersecurity matter’

HHS settles cybersecurity investigation with Montefiore Medical Center

Telehealth availability for mental healthcare varies by state, study finds

Walgreens lays off another 145 employees

HHS finalizes rule on telehealth at opioid treatment programs

Providence erases or refunds $158M in medical bills

Nurse sues UPMC over alleged labor abuses

Centene wins New Hampshire Medicaid contract

Allina Health CFO to depart

Financial distress drove nearly a third of hospital M&A in 2023: Kaufman Hall

Nuance’s AI clinical scribe integrated with Epic is now generally available

Stay Connected