UnitedHealth accused of delaying hospital transfers | CMS ramps up Medicare Advantage audits | Kettering held for ransom

Citing evidence from documents and interviews, the Guardian released an exposé accusing UnitedHealth of directly influencing the day-to-day operations of some 2,000 nursing homes, resulting in patients not receiving necessary emergency care.

The Centers for Medicare & Medicaid Services said it will increase medical coding staff from 40 to 2,000 and begin addressing its backlog of audits on Medicare Advantage plans in an effort to spot signs of fraud and abuse. 

The Ohio-based nonprofit health system did not confirm patient data was exposed and taken by hackers. However, a media report confirmed it has received a ransom notice credited to the Interlock cybercrime cell. 

The U.S. Department of Justice announced the judgment, which was issued against two facilities in Pennsylvania. The nursing homes fraudulently billed Medicare and Medicaid for working hours despite staff not being on the floor. 

The FDA is revising its approach to COVID-19 vaccine approvals, moving away from the previous trend of treating boosters like annual flu shots. Health researcher Vinay Prasad and Commissioner Martin Makary argue in the New England Journal of Medicine for more rigorous data requirements and additional clinical studies to justify future inoculations for those under 65. 

Tom Price, MD, former secretary of Health and Human Services (HHS), said one way to address the growing shortage of physicians is to expand medical resident positions, but these are tied to Medicare spending so alternative means may be needed.

Currently in development, the “Generation Gold Standard” platform utilizes inert whole viruses to combat more strains of common illnesses, such as COVID and the flu. It’s on track for FDA approval in 2029.

The three insurance giants are accused of conspiring with brokers to enroll profitable patients in Medicare Advantage plans, in exchange for "hundreds of millions" in kickbacks.

COVID-19 vaccines are associated with a very low risk of myocarditis and/or pericarditis, primarily in young adults. The long-term impact of this risk has been the subject of many studies and debates over the years. One side says that the benefits of vaccination far outweigh the risks, and the other side says that even the smallest risk of heart damage is too high.

San Jose, California-based Vision Upright MRI allegedly failed to properly assess potential cybersecurity threats and did not notify patients in a timely fashion.