Cone Health, Novant Health partner on joint ownership of insurance company
Cone Health and Novant Health are partnering to jointly own a Medicare Advantage plan currently owned by Cone. Dr. Mary Jo Cagle, CEO of Cone, called the partnership with Novant an "obvious choice." (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - May 18, 2022 Category: American Health Authors: Lillian Johnson Source Type: news

Heart Hospital Pays $1.1 Million in False Claims Settlement Heart Hospital Pays $1.1 Million in False Claims Settlement
The DOJ launched an investigation after Oklahoma Heart Hospital South self-disclosed Medicare billing irregularities related to intensive cardiac rehabilitation services provided to beneficiaries.Medscape Medical News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - May 17, 2022 Category: Consumer Health News Tags: Cardiology News Source Type: news

Private Health Plans During 2020 Paid Hospitals 224 Percent of What Medicare Would Pay
Prices paid to hospitals during 2020 by employers and private insurers for both inpatient and outpatient services averaged 224 percent of what Medicare would have paid, with wide variation in prices among states. (Source: RAND)
Source: RAND - May 17, 2022 Category: Health Management Authors: RAND Corporation Source Type: news

Pay A Little, Get A Little: Medicare ’s Annual Wellness Visit Misses The Mark
Expanding wellness checks to everyone is a band-aid solution to improving overall health. While a wellness visit may help some on the margins, what many seniors under Medicare Plan B receive will be of little benefit. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - May 16, 2022 Category: Pharmaceuticals Authors: Rita Numerof, Contributor Tags: Healthcare /healthcare Innovation /innovation Source Type: news

CMS: Medicaid Program; Reassignment of Medicaid Provider Claims
Notice of final rule from the Centers for Medicare& Medicaid Services (CMS) reinterpreting the scope of the general requirement that state payments for Medicaid services under a State plan must be paid directly to the practitioner or institution providing the service. Under this rule, payments to third parties that provide benefits to the workforce such as health insurance, skills training, and other similar employee benefits will be allowed if the practitioner consents to such payments on their behalf. This rule is effective June 15, 2022. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - May 16, 2022 Category: Rural Health Source Type: news

Faulty Prior Authorization Denials; Smoking & Cancer; Effective Anti-Vaping Messages
(MedPage Today) -- A report from the HHS Office of the Inspector General showed that 13% of prior authorization denials by Medicare Advantage plans involved service requests that met Medicare fee-for-service rules, likely delaying or preventing... (Source: MedPage Today Hematology/Oncology)
Source: MedPage Today Hematology/Oncology - May 13, 2022 Category: Hematology Source Type: news

One in Four Medicare Patients Harmed in Hospitals, Nearly Half Preventable
(MedPage Today) -- Medicare patients continue to experience harm during hospital stays, even after a decade of intensive efforts to decrease provider-caused adverse events, according to a report from the HHS Office of Inspector General (OIG).... (Source: MedPage Today Public Health)
Source: MedPage Today Public Health - May 13, 2022 Category: American Health Source Type: news

Public Inspection: CMS: Medicaid Program: Reassignment of Medicaid Provider Claims
Pre-publication notice of final rule from the Centers for Medicare& Medicaid Services (CMS) reinterpreting the scope of the general requirement that state payments for Medicaid services under a State plan must be paid directly to the practitioner or institution providing the service. Under this rule, payments to third parties that provide benefits to the workforce such as health insurance, skills training, and other similar employee benefits will be allowed if the practitioner consents to such payments on their behalf. This rule is effective 30 days after the publication of this notice, which is scheduled for May 16, 2022....
Source: Federal Register updates via the Rural Assistance Center - May 13, 2022 Category: Rural Health Source Type: news

CMS: Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-January Through March 2022
Quarterly listing of Centers for Medicare and Medicaid Services (CMS) manual instructions, substantive and interpretive regulations, and Federal Register notices published from January through March 2022, including contact information for general questions or additional information about specific sections. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - May 13, 2022 Category: Rural Health Source Type: news

Medicare Is Right Not to Pay for Costly Alzheimer's Drug: Ethicist Medicare Is Right Not to Pay for Costly Alzheimer's Drug: Ethicist
Prof Art Caplan discusses Medicare ' s decision on paying for the use of the Alzheimer ' s drug Aduhelm.Medscape Business of Medicine (Source: Medscape Neurology and Neurosurgery Headlines)
Source: Medscape Neurology and Neurosurgery Headlines - May 11, 2022 Category: Neurology Tags: Neurology & Neurosurgery Commentary Source Type: news

Hospital Errors Worsened During The Pandemic, Say Federal Officials. Now They Want To Suppress The Data.
Hospitals may not be happy about publicly reporting the problems their patients suffered during the pandemic, but Medicare beneficiaries and the public at large deserve to know the truth. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - May 11, 2022 Category: Pharmaceuticals Authors: Leah Binder, Contributor Tags: Healthcare /healthcare Innovation /innovation business Source Type: news

Sleep and Brain Health; Early Amyloid Vaccine Data; New ALS Trial Survival Analysis
(MedPage Today) -- About 7 hours a night was identified as the optimal sleep duration, using genetic and cognitive factors, brain structure, and mental health as key measures, U.K. Biobank data showed. (Nature Aging) Medicare policy changes were... (Source: MedPage Today Neurology)
Source: MedPage Today Neurology - May 11, 2022 Category: Neurology Source Type: news

50 doctors urge Schrader to allow Medicare to negotiate drug prices, cease 'false' ads
Schrader has said that he has taken on drug companies to lower insulin costs. (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - May 10, 2022 Category: American Health Authors: Elizabeth Hayes Source Type: news

AUA, ASTRO release new prostate cancer guideline
The American Urological Association (AUA) and the American Society for Radiatio...Read more on AuntMinnie.comRelated Reading: ASTRO urges members to oppose Medicare payment cuts ASTRO calls proposed CMS cuts 'draconian' ASTRO members exhort Congress to block proposed Medicare cuts Guidelines revised for rad therapy after prostatectomy ASTRO releases new prostate radiation therapy guideline (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - May 10, 2022 Category: Radiology Source Type: news

' Bane of My Existence:' The Burden of Medicare Advantage Denials'Bane of My Existence:' The Burden of Medicare Advantage Denials
Medicare Advantage plans may deny prior authorization and payment requests for medically necessary care that meet Medicare coverage rules, a new report reveals.Medscape Medical News (Source: Medscape Hematology-Oncology Headlines)
Source: Medscape Hematology-Oncology Headlines - May 10, 2022 Category: Cancer & Oncology Tags: Hematology-Oncology News Source Type: news