Compliance & Legal
The FTC got an injunction, pending an appeal, in a process likely to take two years.
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.
The acquisition is likely to increase competition against Atrium Health, which is building a new hospital, judge says.
The ruling could have industry-wide implications for other MA plans seeking to raise their star ratings and bonuses.
Providers may delegate to Change and UnitedHealth the legal requirement for the HIPAA notifications, the OCR has determined.