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Morning Briefing

Summaries of health policy coverage from major news organizations

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Monday, Nov 18 2019

Full Issue

In This World Nothing Can Be Said To Be Certain Except Death, Taxes ... And Health Care Costs Going Up

The National Business Group on Health's CEO Brian Marcotte talks about the current health care landscape and where it's headed in the future. In other health industry news: the Blues team up, a hospital system settles allegations of ADA violations, and more.

The Associated Press: Same As It Ever Was: Worker Health Benefit Costs Rise Again

In the ever-shifting world of company-provided health insurance, here’s a constant: It keeps getting more expensive. Workers may learn that their doctor will no longer be covered or they might have to pay a higher deductible before most coverage begins. Meanwhile, the employer paying most of the insurance bill faces the same big concern every year: The cost will probably rise higher than wages and inflation. (Murphy, 11/17)

Modern Healthcare: Blues Association Launching National Provider Network

Blue Cross & Blue Shield of Illinois is teaming up with other Blue plans to help large employers control rising medical costs and improve care for employees. Known as the Blue high-performance network, the program aims to direct patients toward healthcare providers that consistently offer high-quality care at a lower cost. It's the first program in 25 years to be driven by the Blue Cross Blue Shield Association—a federation of 36 independent Blue companies—rather than the plans themselves, said Jennifer Atkins, vice president of network solutions for the association . (Golderg, 11/15)

Modern Healthcare: Beaumont Settles With Feds Over Alleged ADA Violations

Beaumont Health, an eight-hospital health system based in Southfield, Mich., has reached an agreement with the U.S. attorney's office in Detroit to settle allegations that it violated the Americans with Disabilities Act related to providing communication for people who are deaf or hard of hearing. The complaint alleged that William Beaumont Hospital in Royal Oak, Mich., failed to provide sign language interpreters to deaf patients despite repeated requests for help with medical appointments and procedures, U.S. Attorney Matthew Schneider said in a statement. (Greene, 11/14)

Modern Healthcare: Physician Practices Spend One Staff Day Per Week On Directory Upkeep

Maintaining provider directories is an expensive, time-consuming task that takes up the equivalent of one staff day per week for physician practices, a new Council for Affordable Quality Healthcare survey finds. CAQH, a not-for-profit health plan alliance who members include top health insurers like Cigna, Aetna and Humana, conducted the survey on 1,240 physician practices in September. It found directory maintenance costs practices nationwide $2.76 billion annually, or $999 per practice per month. (Bannow, 11/14)

Sacramento Bee: Sutter Agrees To Pay $15 Million More In Federal Kickback Probe

One day after officials announced a $30.5 million settlement with Sutter Health over kickback allegations, prosecutors in Sacramento revealed the health care giant had agreed to pay an additional $15 million over claims submitted to the federal Medicare program. U.S. Attorney McGregor Scott announced Friday in Sacramento that Sutter had agreed to pay $15,117,516 “to resolve conduct concerning violations of the Physician Self-Referral Law, commonly known as the Stark Law, as well as double-billing for certain services.” (Stanton and Anderson, 11/15)

Miami Herald: Three South Floridians Plead Guilty To Bilking Aetna, Other Insurers

Three former operators of South Florida substance-abuse treatment centers have admitted they ripped off millions from health insurers by submitting false bills for patients who lived in “sober homes” and didn’t need the services, according to their plea agreements. (Weaver, 11/15)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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