In 2021, Modern Healthcare reporters kept readers up-to-date with the latest news, from policy changes and insurance trends to legal woes and labor struggles. Check out these blockbusters below to make sure you didn’t miss any of the biggest stories this year.
Our 15 most-read stories in 2021
1. New 'white glove' debt collector could spell trouble for hospitals, patients
Hospitals are donating unpaid debt to a Tulsa-based not-for-profit that claims to connect patients with social services while also partnering with a debt collector, an arrangement some experts say seems dubious.
Read more here. — Tara Bannow
2. UnitedHealth, Anthem Medicare Advantage plans suspended
Less than a month before open enrollment began, the Centers for Medicare and Medicaid Services suspended Medicare Advantage plans in six states and Puerto Rico because two of the nation's largest insurers charged too much in premiums and failed to spend enough on patient care.
Read more here. — Nona Tepper
3. HHS freezes rule targeting community health centers' drug discounts
The Biden administration in January 2021 delayed a rule that would block community health centers from receiving future grant funds unless they charge low-income patients the acquisition price for insulin and EpiPens, plus an administration fee. HHS has since formally rescinded the proposed rule.
Read more here. — Michael Brady; Jessie Hellmann
4. UnitedHealthcare, Cigna, Aetna all unveil new policies restricting biologics use
UnitedHealthcare, Aetna and Cigna all unveiled policies this year that force patients to switch to biosimilars or restrict the biologic drug dosage an individual can receive.
Read more here. — Nona Tepper
5. Feds: UnitedHealthcare pocketed $3.7 billion in questionable Medicare Advantage payments
UnitedHealth Group generated $3.7 billion in Medicare Advantage payments in 2016 by listing patient conditions unverified through outside medical claims, according to an October report by federal investigators.
Read more here. — Nona Tepper
Los Angeles Times
6. Kaiser Permanente's labor woes worsen as union authorizes strike vote
In September, the labor union representing 24,000 Kaiser Permanente employees paused participation in its labor-management partnership with the integrated health system and is prepared to ask its members to vote on a strike, union leaders said. A strike was eventually averted with a tentative deal in November.
Read more here. — Ginger Christ
7. UnitedHealth loses appeal over Medicare Advantage overpayment ruling
An appellate court ruled against UnitedHealthcare insurers in August, overturning a lower court decision they claimed resulted in underpayment of Medicare Advantage insurers.
Read more here. — Michael Brady
8. CMS requires COVID vaccines for healthcare staff by Jan. 4
In early November, the Centers for Medicare & Medicaid Services announced it will require COVID-19 vaccines for all employees at Medicare and Medicaid-participating healthcare facilities by Jan. 4, and the Occupational Safety and Health Administration announced it will require all employees at businesses with 100 or more workers to be vaccinated by the same date or get tested for the virus weekly. Both are held up in court now, along with a mandate for federal contractors.
Read more here. — Maya Goldman
9. Medicare drops ESRD rule with equity in mind
The Centers for Medicare and Medicaid services unveiled a final rule for next year's end-stage renal disease payments in October that includes a small increase for freestanding and hospital-based dialysis.
Read more here. — Lisa Gillespie
10. Biden repeals Trump-era Medicare 'breakthrough' coverage policy
The Centers for Medicare and Medicaid Services finalized in November its decision to repeal a rule that would have created an expedited Medicare coverage pathway for medical devices considered "breakthrough technology." CMS has since said it intends to release a new version of the rule on next October.
Read more here. — Maya Goldman
11. Hospitals, long-term care providers jockey for doses to the first round of the COVID-19 vaccine
Just over a year ago, in December 2020, healthcare providers were preparing for the roll-out of COVID vaccination campaigns. Big questions remained then about who should receive the first shots.
Read more here. — Steven Ross Johnson and Ginger Christ
12. Nearly 32,000 Kaiser Permanente workers plan strike on Nov. 15
In early November, the United Nurses Associations of California/Union of Health Care Professionals announced nearly 32,000 Kaiser Permanente workers in California, Oregon and Washington planned to strike Nov. 15. Strikes were eventually averted with a tentative deal in November.
Read more here. — Ginger Christ
13. UnitedHealth's limits on out-of-network care seen as surprise billing ban reaction
The big insurer unveiled restrictions on out-of-network coverage just days before CMS published an interim final rule banning much surprise billing.
Read more here. — Nona Tepper
14. Aetna lied about provider network to win Medicaid contracts, suit alleges
Aetna illegally secured contracts with Pennsylvania's Medicaid program by misrepresenting the number of pediatrics providers in its network, according to a federal whistle-blower lawsuit unsealed in September.
Read more here. — Nona Tepper
15. Dying MA customers are switching to traditional Medicare
Medicare Advantage beneficiaries can't access the care they need as they get sicker, a report from federal watchdogs said.
Read more here. — Michael Brady
— Compiled by Aly Brumback, audience engagement specialist
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