UnitedHealth loses appeal over underpayments
A federal appeals court unanimously ruled against UnitedHealth Group over the insurer withholding payments from out-of-network physicians and hospitals to compensate for previous overpayments.
Medicare Advantage industry sees slower growth for 2019
By Shelby LivingstonMedicare Advantage insurers added 1.4 million members to their rosters for 2019, as they looked to grow membership in a market known for being politically safe and predictably lucrative. But membership is growing at slower pace than in previous years.
Medicaid block grant waiver reports revive hospitals' funding worries
The Trump administration is quietly considering allowing states to apply to convert their Medicaid programs into block grants that cap federal spending, which some experts say would lead to lower Medicaid payments for safety-net hospitals.
Research
Fragile pharmaceutical supply chain increases costs, compromises care
The average unit price of drugs in shortage in 2016 increased 23.4%, according to a new report. One in four hospitals had to cut staff to mitigate budget pressures.
Providers
Female physicians more likely to report burnout
Nearly half of physicians report feelings of burnout, and women suffer higher rates of burnout than men, according to a survey by Medscape.
Insurance
Walmart to exit some CVS Caremark pharmacy networks amid reimbursement battle
CVS Caremark's commercial and managed Medicaid customers soon may no longer be able to fill prescriptions at Walmart drugstores amid a dispute between the two pharmacy giants over pricing.
Government
Supreme Court justices lean toward hospitals in Medicare DSH case
Two Supreme Court justices questioned the federal government's assertion that its Medicare DSH formula change didn't amount to substantive policy. The change affects billions of dollars in reimbursement payments.
Finance
HCA-Mission Health deal OK'd by N.C. attorney general
North Carolina's attorney general approved hospital giant HCA Healthcare's $1.5 billion acquisition of Asheville, N.C.-based Mission Health, after nabbing commitments from HCA meant to protect the state's healthcare industry.
Technology
Patient-matching standards must be improved, government report shows
Providers, vendors and others told the Government Accountability Office they still struggle with correctly matching patients to their records, which can theoretically put patients in danger.
Transformation
Plans, providers split on easing Medicaid network adequacy standards
Health plans clashed with providers and consumers in their reactions to the CMS' proposal to give states more flexibility in regulating the adequacy of provider networks in Medicaid managed-care plans.
Safety & Quality
Hospital: Doc gave near-death patients excessive pain meds
An intensive-care doctor at Mount Carmel Health System in Ohio ordered "significantly excessive and potentially fatal" doses of pain medicine for at least 27 near-death patients, sparking two wrongful death lawsuits against the provider.
People
Cerner co-founder Cliff Illig resigns from the company
Illig is leaving the company to focus on "outside interests," including his professional soccer team.
Surveys
Largest health systems, hospital-owned insurers included in new resource guide
Modern Healthcare's 20th annual resource guide features a list of the largest healthcare lobbying organizations and fuller information on lists of vendors and suppliers.
