State Officials, Insurers Push Back At Medicaid Wait Time Reduction Plan
While the White House would like to see Medicaid enrollees not having to wait so long to see a physician, the industry and officials say it's not realistic. Meanwhile, CMS' effort to enforce ratios of nursing home staff to residents may end up in court.
Axios:
Biden's Plan To Reduce Medicaid Wait Times Faces Pushback
The Biden administration wants to make sure Medicaid enrollees don't have to wait too long to see a doctor, but state officials and health insurers that administer the program argue a new plan to speed up appointment wait times is unrealistic. (Goldman, 4/30)
Modern Healthcare:
How The Nursing Home Staffing Rule Could End Up In Court
A nursing home staffing mandate could face court challenges and congressional action as skilled nursing facilities prepare for the first phase of the Centers for Medicare and Medicaid Services rule to go into effect this summer. Hours after CMS finalized the rule last week, nursing home trade group the American Health Care Association said it would “vigorously defend nursing home members by any means necessary and is exploring all options." (Eastabrook, 4/29)
Modern Healthcare:
Medicare Home Health Pay Lawsuit Against HHS Dismissed
A federal court on Friday dismissed a lawsuit against the Health and Human Services Department and the Centers for Medicare and Medicaid Services over Medicare home healthcare payment calculations. The U.S. District Court for the District of Columbia ruled the National Association for Home Care and Hospice failed to exhaust all possible administrative fixes before filing a lawsuit, since it skipped an agency process for seeking expedited review of a new reimbursement method. (Eastabrook, 4/29)
Modern Healthcare:
MultiPlan, Cigna, Aetna, Others Face Allegiance Health Lawsuit
A rural health system sued technology company MultiPlan and eight of the country's largest insurance companies over alleged schemes to strongarm providers into accepting low out-of-network rates. At issue in the proposed class-action suit are MultiPlan's repricing tools, which allegedly rely on insurers' data to deflate their out-of-network reimbursement payments. (Tepper, 4/29)
Modern Healthcare:
Amazon One Medical’s Trent Green Sees Expansion, Not More Layoffs
One Medical CEO Trent Green isn't sold on the term "disruption." The primary care provider was acquired by Amazon, one of the healthcare industry's biggest disruptors, in a $3.9 billion deal in early 2023. But Green said One Medical wants to work with, not replace, traditional healthcare providers to improve care delivery. One Medical has pursued partnerships with health systems and has more in the pipeline, he said. (Hudson, 4/29)
Modern Healthcare:
Talkspace, Charlie Health, Others Partner On Specialty Care
Talkspace is partnering with three other behavioral health providers to broaden in-network access to specialty care and treatment programs. The consortium, which includes Charlie Health, Ria Health, and Bicycle Health, will increase options for specialty behavioral health services for alcoholism, substance abuse and eating disorders, the company said. Talkspace will refer insured members to the other providers. (DeSilva, 4/29)
Modern Healthcare:
Why Nashville Is Becoming A Healthcare Headquarters Hub
Nashville, Tennessee's reputation as an epicenter of the nation's healthcare industry got a boost last week with Oracle Chairman Larry Ellison's announcement that he will relocate the company's world headquarters to the city. Technology giant Oracle, based in Austin, Texas, is making a big push into healthcare. Ellison, who is also the company’s chief technology officer, called Nashville "the center of the industry we're most concerned about." (DeSilva, 4/29)
