Compliance & Legal
The Tukey outlier, guardrails on cut points and the end of Chevron are factors that may influence payer challenges to low 2025 MA star ratings, says Jenn Kerfoot, chief strategy and growth officer at DUOS.
UnitedHealth has also filed a lawsuit, and Elevance says it is considering its options.
CEO Gail Boudreaux says cut points are a large factor driving the decline of plans rated four stars or higher.
The payment is the largest in a healthcare antitrust case, providers say, and settles 12 years of litigation.
A federal investigation uncovered a scheme to steer vendor contracts to medical supply companies in exchange for cash.
Healthcare companies will be required to provide more information to regulators ahead of any proposed mergers.
Bill would establish an electronic prior authorization process for MA plans, including standardization for transactions and clinical attachments.
to make corrective measures in a dispute centered on who is able to access patient data and for what reason.
The contracts do not favor managed care organizations that participate in the state's provider networks, according to plaintiffs.
Norwood Hospital has not been part of the bankruptcy proceedings of Steward's 31 facilities nationwide.