The CMS has approved a waiver that will allow Massachusetts to overhaul its Medicaid program by putting its beneficiaries into accountable care organizations.
About 425 doctors from the New Bedford, Mass.-based system will exit the New England Quality Care Alliance and create their own physician network called the Southcoast Health Network.
The program is modeled after a similar one from Maryland that covers only hospitals. The Vermont ACO will cover Medicare, Medicaid and commercial payers, requiring those who participate to pay similar rates for all services.
Penn State Hershey (Pa.) Medical Center and PinnacleHealth System, Harrisburg, Pa., abandoned their proposed merger in the wake of renewed regulatory opposition from the Federal Trade Commission.
The Massachusetts Association of Health Plans, a lobbying group that represents 17 health plans, has urged state regulators to reject a $1 billion expansion of Boston Children's Hospital.
Danville, Pa.-based Geisinger Health System has acquired Commonwealth Medical College, based in Scranton, Pa., offering the system a pipeline to future doctors.
Vermont has received tentative approval from the Obama administration to establish an all-payer reimbursement system for healthcare providers in the state starting in January.
The Service Employees International Union wants the attorney general of New Jersey to force a sale of five Prime Healthcare Services hospitals in response to a federal lawsuit against the hospital chain alleging it fraudulently billed Medicare.
ConnectiCare said it discussed its planned departure with state regulators and its beneficiaries and ultimately decided to stay in the ACA market. The company had earlier said it would leave in the wake of a state court's Sept. 9 rejection of the insurer's attempt to force through a proposed 27% average premium hike.
Health Republic Insurance of New Jersey will be placed in rehabilitation, which will allow current customers to continue to use their health insurance policies through year-end. The state Banking and Insurance Department said the co-op will advise clients on their 2017 options.
Eric Schneiderman's office is investigating Mylan over “potentially anticompetitive terms” in its sales contracts with school systems in the state. Such terms were discovered in a preliminary review by the attorney general's office, according to a news release.
The Pennsylvania Department of Human Services awarded a massive Medicaid bid last week to AmeriHealth Caritas, Centene Corp. and UPMC after delaying the decision for several months.
Three hospitals within Mount Sinai Health System will pay nearly $3 million to settle a whistle-blower suit alleging they held onto Medicaid overpayments beyond the 60-day repayment window, marking one of the first settlements over an issue that could affect health systems across the country.
Trinitas Regional Medical Center in Elizabeth, N.J. has come to terms with the city to pay $250,000 per year from 2016 to 2019. Another hospital, JFK Medical Center in Edison, N.J., has agreed with the town to maintain its tax-exempt status, but will pay Edison a community service fee of $500,000 in 2016 and 2017.
The doctors staffing New York City's public hospitals stand to lose out on tens of thousands of dollars in incentive payments because of new standards they say are too high.
An HHS audit of inpatient and outpatient claims made by New York-Presbyterian Hospital concluded the mammoth hospital on Manhattan's Upper West Side may have received more than $14.2 million in Medicare overpayments.
Advocate Health Care in Illinois and St. Peter's Healthcare System in New Jersey want the U.S. Supreme Court to weigh in on whether their pension plans should be exempt from certain federal protections for workers.
A subsidiary of Berkshire Hathaway has agreed to acquire New York's largest medical malpractice insurer.
Researchers in Philadelphia will challenge the assumption that a person who is shot or stabbed has a better chance of surviving if he receives more-intensive care before reaching the hospital.
Connecticut's co-op insurer HealthyCT is winding down its business after it was hit with a massive Affordable Care Act risk-adjustment charge, as the state's insurance regulator said the plan was financially unstable because of the required payments.