ACA Case At Supreme Court Next Week Likely To Profoundly Affect Health Care
Justices on Monday will hear arguments in the case of Kennedy v. Braidwood Management, which questions whether the structure of the U.S. Preventive Services Task Force — which makes recommendations for preventive services that nearly all private insurances must cover without cost-sharing — violates the U.S. Constitution’s Appointments Clause.
Stat:
Supreme Court To Hear Challenge To ACA Rule Requiring Free Preventative Care, Cancer Screenings
For a decade and a half, Americans have been guaranteed that no matter their health insurer, certain preventive care like cancer screenings are free of charge. That’s because an Affordable Care Act provision has required insurers to fully cover services given an A or B recommendation by an expert task force. (Chen, 4/17)
More health industry news —
Modern Healthcare:
Humana Medicare Advantage Star Ratings Appeal Denied
Humana's plea for a boost to its Medicare Advantage star ratings has been rejected, the company disclosed Tuesday. The health insurer asked the Centers for Medicare and Medicaid Services for an administrative appeal of the agency's calculation of its quality ratings for 2025, which plunged more than other leading carriers since the prior year. The agency declined last week, although the decision is subject to review by CMS Administrator Dr. Mehmet Oz until April 28, Humana wrote in a legal filing. (Tepper, 4/16)
Modern Healthcare:
Permanente Medical Group, Northwest Permanente Form Affiliation
The Permanente Medical Group and Northwest Permanente said Wednesday they have formed an affiliation. The medical groups will remain separate, but will collaborate clinically and share innovations as part of the agreement. The groups will work together on telehealth, population health and workforce wellness, in addition to pursuing more subspecialty partnerships and scaling IT initiatives, a spokesperson said. (Hudson, 4/16)
Crain's Detroit Business:
Michigan Medicine Faces Lawsuit Over Gender Pay Gap
Michigan Medicine and some of its top executives face a discrimination lawsuit over an alleged gender wage gap between physician assistants. The class action suit, filed Tuesday in Washtenaw County Court, alleges female physician assistants at the health system are paid an average of $9,000 less each year than their male counterparts. (Walsh, 4/16)
Modern Healthcare:
Chapter Lands $75M In Funding From Stripes, Naraya Capital
A Medicare navigation company with ties to a pair of prominent conservatives reached unicorn status with a funding round announced Wednesday. Chapter announced it raised $75 million in a Series D funding round. The round valued the company at approximately $1.5 billion, according to a source with knowledge of the situation. (Turner, 4/16)
Also —
Modern Healthcare:
Remote Patient Monitoring Most Effective Short Term: Peterson
Remote patient monitoring tools can be effective when used in shorter stints, but do not provide a meaningful return on investment for all conditions, according to a new report. The report published Wednesday from the nonprofit Peterson Center on Healthcare found remote patient monitoring programs had mixed results based on the conditions being monitored and the time patients spent in the programs. (Turner, 4/16)
