Georgia sues Biden administration over Medicaid work requirement rollback
The lawsuit claims nixing the mandate the Trump administration put in place is a “bait and switch.”
Medicaid stakeholders warn of hurdles for redeterminations process
Resuming the process of determining whether people are still eligible for Medicaid may sound easy, but stakeholders caution it’s much more nuanced than flipping a switch, and poor planning risks massive enrollment losses.
IBM to sell Watson Health division to private equity firm
Despite the computing giant’s big aspirations for the potential of AI applications in medical research and clinical decisionmaking, Watson Health fell short and is now being sold for an undisclosed amount.
The future of ONC’s interoperability framework hinges on adoption. But the agency — and industry — is optimistic
The government can’t require anyone to adopt TEFCA, raising concerns it won’t see enough voluntary uptake to create the coast-to-coast interoperability network envisaged by ONC. But competitive advantages to participation could get the ball rolling.
4 key trends for payers and providers in 2022
The sectors face continued operational pressure as they head into a third year of the pandemic, including a tight labor market and shifts in payer mix.
Digital therapeutics face barriers to growth as Pear takes early steps toward sales targets
Support for rapid updates, the limitations of current reimbursement policies, cybersecurity risks as well as a “pressing need” for new regulatory frameworks are among the challenges facing DTx companies, according to researchers.
Study finds racial bias in how clinicians describe patients in medical records
Black patients were 2.5 times more likely to have one or more negative descriptor such as “noncompliant” or “aggressive” in their EHR compared with White patients, researchers found.
Diagnostics makers ride omicron surge in COVID-19 test demand. But for how long in 2022?
The highly transmissible variant caused the Biden administration to announce plans to buy 1 billion rapid tests to provide free to Americans. However, when testing will ramp back down remains an open question.
AHIP backs HHS in surprise billing suit, pushes back against provider claims
Relying on the qualifying payment amount, or median in-network rate, helps center the payment dispute, creating a starting point for when payers and providers may need to turn to a third-party arbiter, the lobby argued.
UnitedHealth reiterates MA growth expectations for 2022 as profits eclipse $4B
“Big picture, really positive,” CEO Andrew Witty said about the fruitful MA market, despite dismal projections from some of UnitedHealth’s peers about slowing enrollment.