The two said they’ve been negotiating terms for eight months. Sticking points include denied claims and coverage disputes, with both the insurer and health system pointing fingers. The two said they’ve been negotiating terms for eight months. Sticking points include denied claims and coverage disputes, with both the insurer and health system pointing fingers. | | |
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Bloomberg said the pharmacy benefit manager is being probed as part of a larger look into the “prescription management services” of UnitedHealth. According to sources, this may be related to an ongoing investigation into alleged instances of Medicare Advantage upcoding. Bloomberg said the pharmacy benefit manager is being probed as part of a larger look into the “prescription management services” of UnitedHealth. According to sources, this may be related to an ongoing investigation into alleged instances of Medicare Advantage upcoding. | | |
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CDC Director Susan Monarez, PhD, was less than a month into her role, having been confirmed by the U.S. Senate on July 30. Her lawyers said the staffing shakeup was a result of HHS Secretary Robert F. Kennedy Jr. “weaponizing public health for political gain.” CDC Director Susan Monarez, PhD, was less than a month into her role, having been confirmed by the U.S. Senate on July 30. Her lawyers said the staffing shakeup was a result of HHS Secretary Robert F. Kennedy Jr. “weaponizing public health for political gain.” | | |
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A merger between Eversana and Waltz Health will create a new entity that CEO Mark Thierer says will upend the “existing oligopoly that I helped build.” A merger between Eversana and Waltz Health will create a new entity that CEO Mark Thierer says will upend the “existing oligopoly that I helped build.” | | |
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A new report reveals that states are keeping databases on “imposter nurses” to slow what could be a growing trend of unlicensed individuals holding nursing positions at hospitals nationwide. A new report reveals that states are keeping databases on “imposter nurses” to slow what could be a growing trend of unlicensed individuals holding nursing positions at hospitals nationwide. | | |
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The settlement reached in October 2024 has been finalized. A fund is being set up for the estimated 3 million claimants, as BCBS pledges to reform its BlueCard health plans. The settlement reached in October 2024 has been finalized. A fund is being set up for the estimated 3 million claimants, as BCBS pledges to reform its BlueCard health plans. | | |
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The initial incident happened in April. Since that time, the notorious cybercrime cell Interlock has claimed responsibility. A data dump from the breach was put up for sale on the dark web. The initial incident happened in April. Since that time, the notorious cybercrime cell Interlock has claimed responsibility. A data dump from the breach was put up for sale on the dark web. | | |
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The insurance giant is charging the new board committee with monitoring company policies related to prior authorizations, claims adjudication and AI. The group is scheduled to meet four times a year. The insurance giant is charging the new board committee with monitoring company policies related to prior authorizations, claims adjudication and AI. The group is scheduled to meet four times a year. | | |
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Ladarius Butler took his 3-year-old son to Children’s Hospital Colorado after the boy had trouble breathing. An argument over the care he received led Butler to leave the hospital with the child, prompting staff to call 911. All charges against Butler were dropped, but he has filed a lawsuit against the city of Aurora after he was tased in a Walmart parking lot. Ladarius Butler took his 3-year-old son to Children’s Hospital Colorado after the boy had trouble breathing. An argument over the care he received led Butler to leave the hospital with the child, prompting staff to call 911. All charges against Butler were dropped, but he has filed a lawsuit against the city of Aurora after he was tased in a Walmart parking lot. | | |
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Two lots of IV solution bags from the company were found to contain particulate matter that could cause blockages in blood vessels, killing a patient. To date, no serious adverse events have been reported. Two lots of IV solution bags from the company were found to contain particulate matter that could cause blockages in blood vessels, killing a patient. To date, no serious adverse events have been reported. | | |
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