June 4, 2024

Scan Wins Lawsuit Over Star Ratings

A federal judge said the Centers for Medicare and Medicaid Services violated the Administrative Procedures Act when it deviated from current regulations to calculate Star scores for 2024.  It was a significant win for Scan and Medicare Advantage (MA) plans in general.  It also could throw 2025 bids and benefit designs as well as 2025 Star measure calculations into flux.  I will have a blog on this on Thursday.  In the meantime, check out my LinkedIn post on the issue here: https://www.linkedin.com/posts/marc-s-ryan-%F0%9F%87%BA%F0%9F%87%A6-1a99529_scan-wins-medicare-advantage-star-ratings-activity-7203759541530808320-CEd6?utm_source=share&utm_medium=member_desktop

Additional articles: https://www.beckerspayer.com/payer/scan-beats-cms-in-medicare-advantage-star-ratings-lawsuit.html and https://www.fiercehealthcare.com/payers/judge-sides-scan-health-plan-dispute-cms-over-medicare-advantage-star-ratings and https://www.healthcaredive.com/news/scan-health-plan-medicare-advantage-star-ratings-lawsuit/717976/

(Some articles may require a subscription.)

#stars #medicareadvantage #cms


Steward Gets Permission On Timeline To Sell Assets

Bankrupt Steward Health Care received permission from a bankruptcy judge to sell off its assets on an aggressive timeline.  Federal and state regulators have complained that they may not be able to perform adequate reviews. It is also looking for financing to help make it through the process.

Additional articles: https://www.beckershospitalreview.com/finance/steward-secures-green-light-for-31-hospital-sale-dates.html and https://www.healthcaredive.com/news/Steward-seeks-DIP-financing-amid-liquidity-crisis/717959/ and https://www.modernhealthcare.com/legal/steward-health-care-bankruptcy-timeline-financing-approved

(Some articles may require a subscription.)

#hospitals #bankruptcies #healthcare


AMA May Bring Class-Action Against Change Healthcare On Behalf Of Providers

The American Medical Association may bring a class-action lawsuit against Change Healthcare, Optum, and UnitedHealth Group over the cyberattack.  In addition, Ascension has updated on its cyberattack, saying it expects to restore electronic health records by June 14.

Additional article: https://www.modernhealthcare.com/cybersecurity/ascension-cyberattack-ehr-restored

(Some articles may require a subscription.)

#cyberattacks #providers #changehealthcare #ascension


House Energy and Commerce Subcommittee Tackles 340B Reform

A House Energy and Commerce subcommittee is seeking to create a plan to reform the 340B discount drug program.  Meant to help hospitals and other providers ensure access to drugs by the low income and vulnerable, politicians on each side of the aisle seem to indicate that larger hospital systems may be abusing the program in concert with consolidation and purchase of physician practices.  But no consensus plan yet exists.

Additional article: https://www.modernhealthcare.com/politics-policy/340b-drug-discount-program-reform-genesis-healthcare

(Some articles may require a subscription.)

#340b #hospitals #providers #drugpricing


U.S. Has Highest Maternal Death Rate In Wealthy Countries

The Commonwealth Fund reports that the U.S. has the highest rate of maternal deaths among wealthy nations despite some dip recently. About 80% are preventable and the high rate is tied to a shortage of medical providers.

The stats here mirror Commonwealth Findings on other outcome categories.

#healthcare #outcomes #quality


— Marc S. Ryan

Leave a Reply

Your email address will not be published. Required fields are marked *

Available Now