Citing sources familiar with the matter, the Wall Street Journal reports that UnitedHealth Group is being investigated for criminal fraud, likely stemming from its Medicare Advantage billing practices. Citing sources familiar with the matter, the Wall Street Journal reports that UnitedHealth Group is being investigated for criminal fraud, likely stemming from its Medicare Advantage billing practices. | | |
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A whistleblower lawsuit claims CVS pharmacies have overbilled state Medicaid programs for prescription drugs—a practice allegedly ongoing since 2016. The company denies any wrongdoing. A whistleblower lawsuit claims CVS pharmacies have overbilled state Medicaid programs for prescription drugs—a practice allegedly ongoing since 2016. The company denies any wrongdoing. | | |
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The Massachusetts senator is asking buyer Sycamore Partners for certain assurances, including that it won’t saddle the struggling pharmacy chain with even more debt and indiscriminately close retail locations. The Massachusetts senator is asking buyer Sycamore Partners for certain assurances, including that it won’t saddle the struggling pharmacy chain with even more debt and indiscriminately close retail locations. | | |
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In a lawsuit, plaintiffs allege the company changed course from a long-standing policy of denying medical claims, hiding from investors its impact on profits. The insurer denies any wrongdoing and vowed to defend itself in court. In a lawsuit, plaintiffs allege the company changed course from a long-standing policy of denying medical claims, hiding from investors its impact on profits. The insurer denies any wrongdoing and vowed to defend itself in court. | | |
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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. 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. | | |
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The company cited declining enrollment as the reason for exiting the exchanges, including from patients seeking Medicare options. The company cited declining enrollment as the reason for exiting the exchanges, including from patients seeking Medicare options. | | |
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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. 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. | | |
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Pennant and BrightSpring Health Services have agreed to purchase some healthcare businesses from UnitedHealth and Amedisys. However, it remains unclear whether this will be enough for the DOJ to drop its lawsuit blocking the merger. Pennant and BrightSpring Health Services have agreed to purchase some healthcare businesses from UnitedHealth and Amedisys. However, it remains unclear whether this will be enough for the DOJ to drop its lawsuit blocking the merger. | | |
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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 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. | | |
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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 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. | | |
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