Inaccurate Provider Listings May Become Legal Headache For Insurers
Anthem Blue Cross Blue Shield of New York is facing a class-action lawsuit that alleges that the insurer intentionally includes out-of-network providers in its lists. The insurance industry will be watching closely as others have been accused of promoting "ghost networks."
Modern Healthcare:
'Ghost Networks' Lawsuit May Signal Trouble For Insurers
Health insurers have long faced criticism over inaccurate provider directories, and a recent lawsuit suggests more scrutiny could be on the horizon. Anthem Blue Cross Blue Shield of New York, an Elevance Health subsidiary, is battling a trio of policyholders seeking class action status who allege the insurer deliberately includes out-of-network providers in its lists. These alleged "ghost networks" can deter patients from seeking care or increase their costs and can cause headaches for providers. (Berryman and Early, 12/11)
More health industry updates —
Modern Healthcare:
Community Health Systems To Sell NC Hospital To Duke Health
Community Health Systems signed a definitive agreement to sell a North Carolina hospital to Duke Health for about $280 million. The deal involves the 123-bed Lake Norman Regional Medical Center in Mooresville, North Carolina, and related businesses. It is expected to close in the first quarter of 2025, subject to regulatory approval, according to a Wednesday news release. (Hudson, 12/11)
Modern Healthcare:
Longitude Health To Launch Population Health Company
Longitude Health will launch an initiative next year to help providers improve care for Medicare Advantage beneficiaries and other patients covered by outcome-based reimbursement models. The health system-backed company on Tuesday appointed Dr. Craig Samitt to lead Longitude PHM, which aims to help health systems tackle population health and accelerate what has been a slow shift from fee-for-service to value-based payment models. (Kacik, 12/11)
Minnesota Public Radio:
University Of Minnesota Announces Plans To Restructure M Health System Under New Leadership
The University of Minnesota is taking steps to restructure the M Health system by integrating its physicians within the university under a new leader. The announcement came in a Wednesday memo to medical faculty and staff from the university’s president and the medical school’s dean. (Zurek, 12/11)
KFF Health News:
Patients Couldn’t Pay Their Utility Bills. One Hospital Turned To Solar Power For Help
Anna Goldman, a primary care physician at Boston Medical Center, got tired of hearing that her patients couldn’t afford the electricity needed to run breathing assistance machines, recharge wheelchairs, turn on air conditioning, or keep their refrigerators plugged in. So she worked with her hospital on a solution. The result is a pilot effort called the Clean Power Prescription program. The initiative aims to help keep the lights on for roughly 80 patients with complex, chronic medical needs. (Bebinger, 12/12)
Also —
ProPublica:
How Wall Street Billionaires Avoid Paying Medicare Taxes
For most working Americans, paying their share of the taxes that fund Medicare is an unavoidable fact of life. It’s so automatic for many workers that they may not even realize it takes a bite out of every paycheck. In theory, everyone is required to contribute to the country’s health insurance program for seniors, no matter how poor or rich, from cashiers to CEOs. Not on Wall Street. There, some of the most powerful people in finance found a way to opt out. (Kiel, 12/11)
