Business Intelligence

Providers utilize business intelligence to monitor referral patterns and collaborate with clinicians who order their services. Such analytics tools have also been deployed in the specialty to improve productivity, track patient satisfaction and bolster quality.

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CVS Health sued by coalition of states alleging Medicaid fraud by pharmacies

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.

Optum UnitedHealthcare UnitedHealth Group HQ

UnitedHealth, Amedisys offer divestitures as $3.3B merger advances

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.

Video of how capital investments firms are partnering with hospitals.

Private equity firm Deerfield earmarks $600M for healthcare investments

Deerfield Management released details on its latest Healthcare Innovations Fund program, promising to finance “promising therapeutics” and “elevating emerging technologies," including artificial intelligence. 

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UnitedHealth sued by shareholders over concealing fallout of CEO's murder

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. 

U.S. iodine contrast supply may not be subject to proposed 25% tariffs

If President Trump initiates a 25% tariff against pharmaceuticals imported from Ireland, it might impact the price for X-ray iodine contrast agents in the U.S. depending what rules are put in place.

TV

Report: Former TV writer exploiting ACA to sell bare-bones insurance plans

Bloomberg writes about a company, Quick Health, run by a former comedy writer, who through a loophole in the law is accused of "hiring" members for fake jobs to enroll them in junk insurance policies.

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Florida hospitals sue nonprofit over ‘pay-to-play’ safety rankings

Five Tenet Healthcare hospitals are suing the Leapfrog Group, accusing the organization of pressuring hospitals to share internal data in exchange for higher scores in its annual safety rankings. The watchdog outright denies the claim. 

Tariffs not enough to make Siemens Healthineers move production or raise prices—yet

The imaging manufacturer expects to spend between $227 million and $340 million on tariff mitigation efforts, leaders said Wednesday. 
 

Around the web

After their proposal for a new American Board of Cardiovascular Medicine was shot down earlier this year, cardiology groups have asked the AMA for some support. "We feel like it's time for us to blaze our own path," one specialist explained. 

The company has agreed to acquire Verve Therapeutics for an upfront payment of approximately $1 billion. The total could increase significantly, however, if certain milestones are met. One of Verve's biggest gene therapies has already received the FDA's fast track designation.

American College of Cardiology Board of Governors Chair David E. Winchester, MD, MS, examines the many benefits of working with the American Medical Association House of Delegates to bring about significant change.