Susan Morse
CMS has paid over $2.5 billion to Part A hospitals and more than $717 million to Part B physicians, suppliers and others.
CertifyOS founder and CEO Anshul Rathi engineered a database of providers for payers.
System access was gained via a worker who accidentally downloaded a malicious file, according to the health system.
The decision comes after CMS lost two court cases, but the agency says it reserves the right to appeal.
Because of increasing use of hospital services, growth also accelerated in 2023 for nearly all payers, says Office of the Actuary.
CMS has been ordered to redetermine the star ratings, which Elevance says should be higher.
The current HHS formula costs hospitals more than a billion dollars each year, says AHA.
The court ruled Humana's compliance costs constitute substantial hardship and denied the DOJ's motion to dismiss for lack of standing.
"Today's decision is a victory for Tribal self-determination and Tribal sovereignty," says Mark Macarro.
Cigna and CVS are each other's largest direct competitors and are practically mirror images of one another, court ruling says.