Employer to pay $4.25M to settle claims it failed to consider vaccine exemptions
Recent enforcement involving COVID-19 vaccines appears to go hand in hand with the Trump administration’s broader prioritization of Christian issues.
Senate Democrats move to roll back Medicare AI prior authorization pilot
Lawmakers introduced a resolution to end the WISeR model, which Democrats say is delaying and denying seniors care.
Tenet hospitals, Leapfrog spar over legal fees in hospital ratings case
The Tenet-owned hospitals want Leapfrog to pay $10.5 million in legal fees after a judge agreed that the nonprofit unfairly deflated their ratings. The penalty would “cast a specter of financial ruin” over the nonprofit, Leapfrog said.
CommonSpirit $3.4B in the red amid billing contract exit, operational woes
The Catholic nonprofit giant’s expenses well outstripped revenue in the most recent financial quarter. Though the outcome was mostly due to one-time items, CommonSpirit also continues to struggle with boosting core operations.
Tenet, Leapfrog spar over legal fees in hospital ratings case
Tenet wants Leapfrog to pay $10.5 million in legal fees after a judge agreed that the nonprofit unfairly deflated Tenet’s hospital ratings. The penalty would “cast a specter of financial ruin” over the nonprofit, Leapfrog said.
Aetna’s chief digital and technology officer on how the insurer is using AI for patient engagement
Nathan Frank discusses how the insurer is using AI to engage members, how the company thinks about risks, and the importance of monitoring the tools and soliciting feedback.
CMS finalizes major changes to ACA exchanges, including greater access to catastrophic plans
The Trump administration continues to open the doors to the cheap, high-deductible coverage, to the worry of insurance experts and stakeholders in the healthcare industry.
Employer groups, unions urge Trump administration to reform No Surprises dispute resolution
Providers are reaping high award amounts, and arbiters have “structural conflicts of interest” that incentivize a high volume of disputes, driving up healthcare costs for employers and patients, the groups wrote.
Why patients feel the difference in an automated practice (even if they don’t know it)
Patients don’t see automation, but they feel smoother, more connected care.
Emergency medicine revenue at risk: Navigating the algorithmic squeeze
Diagnosis-based downcoding is surging. Emergency physicians are paying the price.