Susan Morse
A class-action lawsuit has reportedly been filed against the Pennsylvania health system for the data breach.
CFOs want value-based contracts with commercial plans as the payer mix changes to one more heavily dependent on Medicare and Medicaid.
The parties have not yet withdrawn material change notice filings with the Massachusetts Health Policy Commission.
The current pharmacy model is unsustainable as Walgreens is in discussions with PBM and payer partners to get paid fairly, CEO says.
The rule also proposes to extend Medicare payment to dialysis in the home setting for beneficiaries with acute kidney injury.
Akron Children's Hospital gets half its reimbursement from Medicaid, with all health systems facing a changing payer mix.
Mike Vigo, chief revenue officer at UCSD, addresses the "Revenue Cycle Management Technology Adoption Model" at HFMA.
The action of PBMs, combined with those of manufacturers, distributors and pharmacies created the opioid crisis, lawsuit says.
The drugs will have a lowered Part B coinsurance rate, since each drug company raised prices faster than the rate of inflation.
"Plans continue to use AI tools to erroneously deny care and contradict provider assessment findings," lawmakers say.