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More Information On Elevance Health Star Lawsuit Win Yesterday we told you about Elevance Health’s win in court on the 2024 Star calculations.  Other healthcare publications have written stories today.  The pressure is on the Centers for Medicare and Medicaid Services (CMS) to respond.  I have also linked the lawsuit below. Additional articles: https://www.modernhealthcare.com/insurance/elevance-medicare-advantage-star-ratings-lawsuit-cms and https://www.beckerspayer.com/payer/elevance-health-gets-partial-victory-in-star-ratings-lawsuit.html#:~:text=The%20judge%20ruled%20partially%20in,only%20for%20BCBS%20of%20Georgia.  and https://www.healthcaredive.com/news/elevance-wins-medicare-advantage-star-ratings-lawsuit-hhs/718550 Opinion: https://www.documentcloud.org/documents/24740919-elevance_becerra_6724_order (Some articles may require a subscription.) #medicareadvantage #stars #cms https://www.fiercehealthcare.com/payers/elevance-health-earns-partial-win-legal-fight-over-ma-star-ratings Hospitals Raise Issues With Medicare Rate Hike And Requirements Hospitals pushed back on the Centers for Medicare and Medicaid Services’ (CMS) proposed regulatory changes and rate hikes. Hospitals raised concerns about new quality reporting requirements and changes to medical residency training programs.  It claimed the 2.6% rate hike was inadequate. At the same time, hospitals are opposing site-neutral payments, which would save the system and patients huge sums. #hospitals #medicare https://www.fiercehealthcare.com/providers/hospital-groups-push-back-cms-woefully-inadequate-inpatient-pay-bump-fy2025 Humana Finds VBC Payments Impact Kidney Care Humana has

Elevance Wins Star Lawsuit A second lawsuit has been decided in favor of a Medicare Advantage (MA) plan and against the Centers for Medicare and Medicaid Services (CMS) on the calculation of Star scores. In this case, Elevance Health won its suit and a judge declared that Georgia contract scores must be revised. It will be increasingly difficult for CMS to ignore these rulings. I will write on this on LinkedIn tomorrow. (Article may require a subscription.) #medicareadvantage #cms #stars #elevancehealth https://www.modernhealthcare.com/insurance/elevance-medicare-advantage-star-ratings-lawsuit-cms White House Announces Cybersecurity Support For Hospitals The White House announced that Microsoft and Google will provide free or discounted support to help hospitals strengthen their cybersecurity. (Article may require a subscription.) #hospitals #cybersecurity https://www.modernhealthcare.com/politics-policy/google-microsoft-cybersecurity-rural-hospitals-safety-net Supreme Court To Hear Hospital Funding Case The Supreme Court said it will review a lower court decision that limits Medicare payments for hospitals under the federal disproportionate share hospital program. It is a rather

Oscar Continues Good Performance, Lays Out Strategy Oscar Health reports its first quarterly net profit and hit 1.5 million enrollees in the Exchanges. It plans on investing in individual coverage health reimbursement arrangements (ICHRA) in tandem with its Exchanges offerings as well as re-entering Medicare Advantage. Additional article: https://www.beckerspayer.com/payer/oscar-health-plans-to-double-its-membership-5-things-to-know.html #oscar #exchanges #aca #obamacare #ichra #medicareadvantage https://www.fiercehealthcare.com/payers/oscar-health-growth-ambitions-doubling-its-footprint-planned-ichra-products-launch-and-more The Troubles Of Retail Meets Healthcare Good article on the general struggles with low-reimbursed primary care and additional challenges retailers have had. #retailmeetshealthcare #primarycare #healthcare https://www.fiercehealthcare.com/retail/industry-voices-walmarts-exit-health-centers-reflects-broader-challenges-primary-care Kroger Health Offering GLP-1s Kroger Health joins a growing number of providers driving expensive GLP-1 weight-loss drugs.  This is bound to continue to drive the shortages those with disease states face. (Article may require a subscription.) #kroger #weightlossdrugs #drugpricing https://www.modernhealthcare.com/patient-care/kroger-health-little-clinics-glp-1s-wegovy-zepbound Walgreens Will Not IPO Boots Struggling Walgreens Boots Alliance Inc. is killing an initial public offering for its UK Boots drug chain. It may still be looking for