About health insurance
Anesthesiologists ask for investigation on alleged UnitedHealth anti-competitive actions: “The American Society of Anesthesiologists called on the Justice Department Oct. 7 to have its Antitrust Division investigate alleged anti-competitive behavior from UnitedHealth Group.
The letter alleges UnitedHealth Group's termination of contracts with anesthesiologists is forcing them to work out-of-network, thereby incentivising patients to use the company's own anesthesiologists, according to an Oct. 7 news release.
The group also claims that UnitedHealth Group's vertical integration allows it to steer UnitedHealthcare members toward the anesthesiologists under Optum, which it also own…
’Unfortunately, a small number of groups, many of which are private equity-backed, are working to protect their ability to continue charging egregiously high rates,’ a UnitedHealthcare spokesperson told Becker's. ‘The real reason many of them no longer participate in our network is because they expect to be paid double or even triple the median rate we pay other physicians providing the same services…’”
US to join suit against Tennessee health system alleging $800M in fraud: “The lawsuit claims physicians at West Clinic were given kickbacks for referrals of cancer patients for hospital admissions, chemical infusions, radiation and certain outpatient procedures.
The lawsuit claims the scheme took place from 2012 to 2018 and that Methodist Le Bonheur paid more than $400 million in kickbacks to West Clinic. Additionally, the lawsuit claims the scheme resulted in $800 million in fraudulent claims being submitted to Medicare.”
Introducing the new Ochsner Health Plan -- offering Medicare Advantage!: “This October, Louisiana residents eligible for Medicare will have the opportunity to enroll in Medicare Advantage benefit plans offered by the all-new Ochsner Health Plan…
Ochsner Health Plan will work collaboratively with Ochsner Health’s participating providers…”
PopHealthCare launches new national medical group, Emcara Health: “Emcara Health, is backed by support from GuideWell, which is also the parent company of Blue Cross and Blue Shield of Florida, or Florida Blue. The company is aiming to become a market leader in home care through its slate of services, including a 24/7 Home-Based Advanced Primary Care offering, aimed at seniors and adults.”
About hospitals and health systems
Dana-Farber reverses trustee investment policy: “Two longtime Dana-Farber Cancer Institute trustees have resigned, and the Boston-based institute will no longer permit board member investment in hospital startups after a recent Boston Globe investigation revealed that some trustees had opportunities for personal enrichment through investing in hospital-grounded startups…
The newspaper's investigation revealed that at least nine trustees have leadership positions in venture capital and investment firms that hold shares in startups grounded in Dana-Farber research. One trustee, entrepreneur and venture capitalist, Marc Cohen, launched five startups grounded in Dana-Farber research between 2008 and 2021. For one of these startups, C4 Therapeutics, Mr. Cohen's shares had increased by approximately $85 million as of September…
Dana-Farber is the only hospital the Globe contacted that explicitly supported trustees who invest in its startups.”
About healthcare IT
Best Buy to acquire Current Health to help make home the center of health: “Best Buy has signed an agreement to acquire Current Health, a leading care-at-home technology platform that brings together remote patient monitoring, telehealth, and patient engagement into a single solution for healthcare organizations.
About pharma
The Public Weighs In On Medicare Drug Negotiations: “…the latest KFF Tracking Poll finds large majorities support allowing the federal government to negotiate and this support holds steady even after the public is provided the arguments being presented by parties on both sides of the legislative debate (83% total, 95% of Democrats, 82% of independents, and 71% of Republicans)…
While 85% of adults ages 65 and older report having some type of insurance that helps pay for prescription drugs, one in five older adults still report difficulty affording their prescription drugs, including 17% of older adults with some type of prescription drug coverage. The share who report difficulty affording prescription drugs increases to more than one in four among adults 65 and older who take four or more prescription drugs.”