The list includes diagnostics and common care associated with oncology, orthopedics and ENT care for patients under the age of 18. The company framed the change as a part of its ongoing commitment to eliminate 30% of all pre-care reimbursement approvals by 2027.
The big announcement was made on Wednesday, and many of the details are still being worked out ahead of the planned 2028 split of the company. For now, the plan is for CVS Health to retain its core Caremark and Aetna businesses, with the pharmacy company to take over prescription drug sales and urgent care services.
The agency did not name the companies or accuse them of wrongdoing. Instead, it told the companies they are ‘on notice’ and reminded them about federal laws, including the limited use of telemarketing.
Syed Murtuza Kablazada, 36, an Indian national and resident of Illinois, could spend 20 years behind bars for submitting false medical claims for COVID-19 tests to the federal healthcare program. Authorities said Medicare paid out $136 million for lab results that were faked.
In an open letter, the American Hospital Association and American Medical Association, among others, are asking regulators to delay the rollout of the Ambulatory Specialty Model, a value-based reimbursement structure for patients with heart failure and lower back pain.
Expanded assessments of geriatric patients that include simple interventions like noise-cancelling headphones have seen success in the form of reduced inpatient admission rates.
A coalition of 26 states challenging the implementation of Medicaid work requirements finds some success, but they will largely go into effect on Jan. 1 as planned.
