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Healthcare news this week …

Obamacare sign-ups down 550,000 as deadline nears

Obamacare sign-ups down 550,000 as deadline nears

December 12, 2018

HealthCare.gov sign-ups lag by more than a half-million with less than a week left in open enrollment. Last-minute shoppers and a surge of auto-enrollments should boost the finally tally, but enrollment is likely to fall short last year.

DOJ joins whistle-blower lawsuit against Sutter Health

DOJ joins whistle-blower lawsuit against Sutter Health

December 12, 2018

The U.S. Department of Justice has intervened in a whistle-blower lawsuit against Sutter Health that accuses the health system of submitting unsupported diagnosis codes to inflate its Medicare Advantage payments.

Blues antitrust case just got tougher for the insurers

Blues antitrust case just got tougher for the insurers

December 12, 2018

A federal appeals court on Wednesday ruled that Blue Cross and Blue Shield insurers must defend themselves on much less favorable legal grounds against a major class-action case accusing them of anticompetitive practices.

Gilfillan to leave Trinity Health in 2019

Gilfillan to leave Trinity Health in 2019

December 11, 2018

Trinity Health CEO Dr. Richard Gilfillan plans to step down from the helm of the Livonia, Mich.-based system in June 2019. He will be succeeded by Michael Slubowski, who currently serves as Trinity's president and chief operating officer.

Target to pay $3M to resolve Massachusetts Medicaid claim

Target to pay $3M to resolve Massachusetts Medicaid claim

By Associated Press  |  December 11, 2018

Federal and Massachusetts authorities allege Minneapolis-based Target violated federal and state False Claims Acts by automatically refilling Medicaid recipients' prescriptions and seeking payment from Medicaid.

UnitedHealthcare, Envision renew contract after ED billing dispute

UnitedHealthcare, Envision renew contract after ED billing dispute

December 11, 2018

UnitedHealthcare and physician staffing company Envision Healthcare have renewed their contract for 2019, resolving a dispute over Envision's ED billing practices that threatened to leave patients on the hook for surprise out-of-network medical bills.

Congress to pass children's health home legislation by year-end

Congress to pass children's health home legislation by year-end

December 10, 2018

Congress is considering a revised bill to establish provider-coordinated health homes for chronically ill children during its lame duck session. The U.S. House of Representatives has cut the amount of federal Medicaid money that would fund the homes.

Data show link between childhood trauma, adult health

Data show link between childhood trauma, adult health

By Associated Press  |  December 10, 2018

While only 10% of adults with no adverse experiences during childhood reported being in fair or poor health, that percentage was 17% for those with at least one such experience, according to new data.


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