CMS Finalizes Rule Streamlining Prior Authorization Process
The Centers for Medicare and Medicaid Services finalized the CMS Interoperability and Prior Authorization Rule on Wednesday. CMS said the rule will improve the prior authorization process and save about…
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AMA President: Medicare Physician Pay Cuts Will Have ‘Dire’ Impact if Not Reversed
Reversing the 3.37% Medicare pay cut that went into effect for physician practices on January 1 is a top priority for the American Medical Association, said Dr. Jesse Ehrenfeld, president…
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How Digital Health Fundraising Took On a Different Shape in 2023
U.S.-based digital health startups ended 2023 with a fundraising total of $10.7 billion across 492 deals, which is the lowest annual fundraising amount the sector has seen since 2019, according…
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Both Have Done Wrong, Expert Says On UHC/Mount Sinai Contract Dispute
In another case of payer/provider tensions, Mount Sinai is out of network for UnitedHealthcare’s employer-sponsored and individual plans (including Oxford Health Plan) as of January 1 due to payment disputes….
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Goldman Sachs Closes $650M Fund to Invest in ‘Golden Era’ of Biotech Innovation
Goldman Sachs Asset Management has expanded to biotech investments in recent years. The investment firm is now preparing to ramp up its investment activity in the sector with a new…
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5 Most Notable Hospital M&A Deals in 2023
Hospitals and health systems have experienced extreme financial pressure in the past couple years — and the issue is being reflected in the sector’s M&A activity. There have been dozens…
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Arcadia Sells Its Value-Based Care Division to a Fledgling Startup
A nascent healthcare startup announced an acquisition on Thursday that it believes will advance its mission of accelerating the industry’s transformation to value-based care. Guidehealth — a value-based care enablement…
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Sanofi Abandons Deal for Rare Disease Drug Amid FTC’s Monopoly Concerns
Sanofi is walking away from a deal to license an experimental Maze Therapeutics drug for a rare enzyme deficiency after the Federal Trade Commission challenged the transaction as anti-competitive. The…
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FDA Probes New Cases of Cancer That May Stem From Cancer Cell Therapies
The FDA is investigating whether CAR T-therapies—cell therapies approved for treating advanced cases of blood cancer—are sparking secondary cases of cancer. The agency announced Tuesday that it has received reports…
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FTC Sees Red Over Alleged Misuse of FDA Orange Book, Puts 10 Pharmas on Notice
AbbVie, AstraZeneca, and GSK are among the 10 companies now under scrutiny by the Federal Trade Commission, which is cracking down on businesses it says improperly or inaccurately placed items…
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What Excites Health Execs About the Evolution of Employee Benefits
From left to right: Kate Huey, partner, business transformation leader for health care, Ernst & Young; Jeffrey Ries, executive director, JPMorgan Chase & Co.; Chris Turner, CEO, HealthBook+; Bipinchandra (Bipin)…
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Why VCs Aren’t Interested in Point Solutions
From left to right: Hubert Zajicek, MD, CEO, co-founder & partner, Health Wildcatters; Kristen Torres Mowat, partner, Health Velocity Capital; Harsh Vathsangam, CEO, Movn Health; Kerry Rupp, general partner, True…
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Did Cigna Deserve its $172M Penalty?
After Cigna agreed to pay $172 million to resolve allegations that it violated the False Claims Act in its Medicare Advantage plans, it begs this question: Is the insurer deserving…
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These 10 Trends Are Affecting The Healthcare Economy The Most
Last week, healthcare-focused market research firm Trilliant Health released a report detailing the most significant economic trends affecting stakeholders in the U.S. healthcare sector this year. Some of the main…
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Amicus Therapeutics Rare Disease Combo Therapy Wins Long-Awaited FDA Nod
An Amicus Therapeutics combination treatment for the rare enzyme deficiency Pompe disease now has FDA approval, giving the drugmaker the opportunity to help patients who don’t respond to Sanofi products…
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4 States Received Enhanced Medicaid Funding During Covid Despite Wrongly Terminating Coverage
Four states did not meet all of the requirements to receive enhanced federal Medicaid funding during the Covid-19 public health emergency, a new Office of Inspector General (OIG) report found….
Read More » HHS: Medicaid/CHIP Coverage To Be Reinstated for 500K People
After determining an issue in the way many states were handling Medicaid and CHIP redeterminations, the U.S. Department of Health and Human Services (HHS) announced Thursday that coverage will be…
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85,000 Kaiser Workers Will Soon Vote to Authorize What Could Be the Biggest Healthcare Strike in US History
On Thursday, the Coalition of Kaiser Permanente Unions announced that it will begin conducting strike authorization votes among its 85,000 members starting next Monday and going through September 13. The…
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Spring Health Launches Mental Health Education Platform for Workplaces
At a time when mental health support is becoming a must-have for employees in their workplaces, only 42% of managers feel they can fully help their company with its wellbeing…
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43K Patients in California Could Get Refunds, Bill Corrections As Part of Discounted Care Settlement
On Monday, Santa Clara Valley Healthcare in California began notifying 43,000 patients about their eligibility for billing corrections and refunds. The health system includes a network of primary and specialty…
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