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Healthcare News

 

Study: Medicaid expansion has not spurred more hospital charity care spending

2/27/2020


(FierceHealthcare)
Medicaid expansion successfully reduced nonprofit hospital spending on uncompensated care—but that doesn't mean they're spending more on charity care, a new study shows.


Rather than freeing up funds at hospitals for increased spending on other charitable efforts to support community health—as the Affordable Care Act (ACA) intended when it expanded Medicaid—a new study found gains were instead used to offset a corresponding uptick in unreimbursed Medicaid expenses.


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Needy patients 'caught in the middle' as insurance titan drops doctors

2/25/2020


(FierceHealthcare)
BAYONNE, N.J. — For five years, Rasha Salama has taken her two children to Dr. Inas Wassef, a pediatrician a few blocks from her home in this blue-collar town across the bay from New York City.


Salama likes the doctor because Wassef speaks her native language—Arabic—and has office hours at convenient times for children.


“She knows my kids, answers the phone, is open on Saturdays and is everything for me,” she said.


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Blue Cross Blue Shield of Michigan adds 7 providers to value-based care model

2/24/2020


(FierceHealthcare)
Blue Cross Blue Shield of Michigan has added seven more providers to its Blueprint for Affordability value-based care program, taking the initiative statewide. 


Blue Cross unveiled the program in December, and the first seven health systems to sign on were largely clustered in the southeastern part of the state. Initial participants included Henry Ford Health System, Ascension Michigan and Michigan Medicine. 


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Health insurers' profits topped $35B last year. Medicare Advantage is the common thread

2/24/2020


(FierceHealthcare)
Big-name health insurers raked in $8.2 billion in profit for the fourth quarter of 2019 and $35.7 billion over the course of the year.


The common theme in their financial success? Growth in Medicare Advantage (MA). Of the seven biggest national insurers, all but one saw notable growth in their MA enrollment by the end of 2019.


Many were projecting even bigger expansion to come in 2020.


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Study: Pharma payments to docs led to nearly 4% boost in prescription spending

2/20/2020


(FierceHealthcare)
A study found that drug company payments to physicians led to a nearly 4% uptick in prescriptions, a smaller impact compared to other research.


The study, released Thursday from the National Bureau of Economic Research (NBER), tackles the controversial practice of pharmaceutical manufacturers paying doctors to speak at conferences, get meals or cover educational expenses. The study also examined the role payments played in the transition of patients from a brand-name drug onto a generic.


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Florida woman doing 35 years in prison for Medicare fraud has sentence commuted by Trump

2/19/2020


(FierceHealthcare)
A Miami woman sentenced to serve 35 years in prison for Medicare fraud had her sentenced commuted by President Donald Trump.


Judith Negron, 48, was among the 11 federal inmates Trump announced pardons and commutations for Tuesday, according to the Tampa Bay Times.


Negron was sent to prison for her part in a $205 million fraud case in what was then the country’s biggest mental health billing scheme, according to the report.


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Survey: Many Medicare beneficiaries fear receiving a surprise medical bill

2/18/2020


(FierceHealthcare)
A majority of Medicare beneficiaries are worried about getting a surprise medical bill as Congress ponders how to handle the issue.


A survey from the online insurance exchange eHealth found that 63% of beneficiaries are worried about getting hit with a surprise bill. Other major concerns included rising cost-sharing and out-of-pocket expenses.


“Our survey shows that surprise medical bills aren't only a concern for the pre-Medicare population but for Medicare enrollees as well," said eHealth CEO Scott Flanders in a statement.


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Congress is eyeing 3 paths to end surprise billing. Here's what they look like

2/14/2020


(FierceHealthcare)
The House of Representatives is in the middle of trying to decide which three pieces of legislation to endorse that will end surprise medical bills.


All three have advanced out of their respective committees, with two of them advancing this past week, but some differ considerably in terms of how providers will be paid for out-of-network charges.


Below is a quick rundown of what each House committee wants:


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Doctor allegedly took $26 million from insurers with phony medical procedures: Prosecutors

2/16/2020


(ABC NEWS)
Federal prosecutors charged a Florida doctor for allegedly taking $26 million from Medicaid, Medicare and other health insurance for phony health procedures.


Dr. Moses D. Degraft-Johnson pleaded not guilty to several criminal counts filed by the U.S. District Court for the Northern District of Florida on Thursday, including health care fraud and conspiracy to commit health care fraud.


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Private equity firms in Congress' crosshairs with legislation calling for transparency

2/12/2020


(FierceHealthcare)
Private equity firms that have been gobbling up physician practices should watch out for congressional efforts to rein them in.


The House Ways and Means Committee advanced a bill Wednesday to force private equity firms that own physician practices to provide the federal government with information on payments and real estate investments. The legislation is the latest bid by lawmakers to scrutinize such firms that critics have said are a driving force behind surprise medical bills.


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