Change Healthcare’s Claims Center Is Back Online Months After Cyberattack
Change Healthcare is the largest clearinghouse for billing and payments in the U.S. The company is still working to restore other technology platforms affected by the ransomware attack in February.
Modern Healthcare:
Change Healthcare Breach: Clearinghouse Platform Restored
Change Healthcare’s vital clearinghouse platform has been restored after a cyberattack on the UnitedHealth Group subsidiary caused unprecedented billing and payment disruptions for providers nationwide, the company announced on its status webpage. This is a big step for the technology company after its systems were taken offline following a February ransomware attack that caused widespread disruptions throughout the healthcare system. (Berryman, 11/19)
In other health industry updates —
Modern Healthcare:
Medicare Advantage Markets See Competition Shifts In 2023: AMA
Competition among Medicare Advantage insurers has accelerated slightly on a local level over the past six years, according to the American Medical Association's annual report on the industry. The average number of insurers selling Medicare Advantage plans in a single metropolitan area increased between 2017, when the AMA started tracking market share, and 2023. Individual companies' average market share also decreased. Nearly every market, however, was still considered "highly concentrated" according to Federal Trade Commission and Justice Department standards. (Tepper, 11/19)
CNBC:
CVS, UnitedHealth, Cigna Sue To Block FTC Case Over Insulin Prices
CVS Health, UnitedHealth Group and Cigna sued the Federal Trade Commission on Tuesday, claiming that the agency’s case against drug supply chain middlemen over high insulin prices in the U.S. is unconstitutional. The complaint, filed in the U.S. District Court for the Eastern District of Missouri, is the latest move in a bitter legal fight between the three largest pharmacy benefit managers, or PBMs, in the U.S. and the FTC. (Constantino, 11/19)
WLRN Public Media:
Baptist Health Plans To Open A Cancer Center In Key West
After more than a year without a dedicated cancer treatment center in Key West, cancer care is expected to return to the Lower Keys. GenesisCare cancer treatment center closed in August 2023, when its parent company filed for bankruptcy. Since then, Lower Keys cancer patients have had to find alternative treatment locations, in some cases driving three hours, over 100 miles away. Now, Baptist Health is planning to expand its cancer care and open a treatment center at the site of the former GenesisCare center, on North Roosevelt Boulevard. (Cooper, 11/19)
Modern Healthcare:
Oak Street Health Co-Founder Mike Pykosz To Leave CVS Health
Mike Pykosz is no longer president of healthcare delivery at CVS Health. Pykosz, who co-founded Oak Street Health and was CEO when it was acquired by CVS in 2023, has decided to leave the company and will be replaced by Chief Medical Officer Dr. Sreekanth Chaguturu, according to a Tuesday news release. Chaguturu will continue his role as chief medical officer at CVS, the release said. (Hudson, 11/19)
Crain's Cleveland Business:
Ex-MetroHealth CEO Dr. Akram Boutros Refiles Lawsuit
Ex-MetroHealth CEO Dr. Akram Boutros has filed a lawsuit against the health system one week after the Ohio Auditor of the State’s office released a report saying his actions involving the bonuses he paid himself were not criminal. The lawsuit, filed Tuesday, Nov. 19, in the Cuyahoga County Court of Common Pleas, accuses MetroHealth of breach of contract, promissory estoppel and defamation. It alleges that MetroHealth’s Board of Trustees “unjustly fired” Boutros from his position and “publicly defamed” him with “baseless accusations that he received unearned incentive compensation without the Board of Trustees’ knowledge.” (Bennett, 11/19)
KFF Health News:
Ex-Eye Bank Workers Say Pressure, Lax Oversight Led To Errors
William Lopez remembers clearly the day in June 2017 when he says he was asked to call the spouse of a college friend who had just died and ask for her eyes. The spouse hadn’t responded to calls from other employees at the Rocky Mountain Lions Eye Bank, he said. As Lopez recalled, his supervisor thought a friend’s personal number would have more success. Lopez refused. “I went for a walk,” he said. (Beck and Bichell, 11/20)
KFF Health News:
FTC, Indiana Residents Pressure State To Block Hospital Merger
Indiana residents and federal officials are urging state health regulators to stop two rival hospitals in Terre Haute from merging. The deal, if approved, would leave residents with a hospital monopoly. Union Health, a nonprofit whose main hospital is licensed as a 341-bed facility, would buy the county’s only other acute care hospital, the 278-bed Terre Haute Regional Hospital, owned by for-profit chain HCA Healthcare and located 5 miles south across the city’s downtown area. Union says the merger to create one larger nonprofit health system would improve the area’s poor public health rankings. (Liss, 11/19)
KFF Health News:
Listen: A Tussle With A Rattlesnake Can Take A Bite Out Of Your Wallet
This spring, a San Diego toddler spent two days in a pediatric intensive care unit after a rattlesnake bit his hand in his family’s backyard. The bills that followed were staggering, with the lifesaving antivenom the 2-year-old needed accounting for more than two-thirds of the total cost — $213,000. Why is antivenom so expensive? One explanation is the markup hospitals add to balance overhead costs and make money. Another explanation is a lack of meaningful competition. There are only two rattlesnake antivenoms approved by the Food and Drug Administration. (Fortiér, 11/20)
