UnitedHealthcare Gets Pushback On New Policies For Lab, Drug Payments
The American Hospital Association wrote a letter to the Centers for Medicare and Medicaid Services last week, urging it to take action on both policies.
Modern Healthcare:
Hospitals Fight UnitedHealthcare Policies Over Lab Test, Specialty Drug Payments
Hospitals are pushing back against new UnitedHealthcare policies that threaten payments for lab tests and specialty drugs in outpatient settings. The country's largest private health insurer, with more than $200 billion in revenue in 2020, is cutting off reimbursement to diagnostic labs that don't meet certain price and quality criteria. UnitedHealthcare is also taking over the process of supplying certain outpatient specialty drugs to hospitals rather than reimbursing hospitals for those drugs. (Bannow, 2/5)
Modern Healthcare:
Long-Term Care Providers Prepare To Fend Off COVID-19 Lawsuits
Long-term care providers and their lawyers are preparing to defend the industry against claims of neglect and wrongful death of residents as lawsuits related to the COVID-19 pandemic start being filed nationwide. While plaintiff lawyers say residents are being neglected, defense lawyers say long-term care providers have been working hard to follow changing regulations on testing, personal protective equipment and infection control during a global pandemic that targets the elderly and puts intense pressures on healthcare providers. On both sides, lawyers are preparing to argue cases where the rules are still being determined. (Christ, 2/6)
Capital & Main:
Podcast: For-Profit Hospital Deserts Pandemic-Wracked Los Angeles
An interview with Shenita Anderson, an ER nurse at L.A.’s for-profit Olympia Medical Center, which is closing despite the COVID-19 crisis. (2/3)
Las Vegas Review-Journal:
Nevada Health Centers Reports Data Breach
Personal information of patients at Nevada Health Centers “potentially” was accessed during a data breach last fall, the organization announced Friday. An unknown person logged into an employee’s email account and “potentially accessed” patient names, addresses, phone numbers, dates of birth, gender, ethnicity and race, insurance and appointment information, medical record number, provider names and locations of service for an unknown number of patients sometime between Nov. 20 and Dec. 7, according to a statement Friday night. Social security numbers, financial information and medical records were not accessed, the statement said. It did not say how many patients were affected. (Schnur, 2/5)
KHN:
Community Health Workers, Often Overlooked, Bring Trust To The Pandemic Fight
For 11 months, Cheryl Garfield, a community health worker in West Philadelphia, has been a navigator of pandemic loss and hardship. She makes calls to people who are isolated in their homes, people who are sick and afraid and people who can’t afford their rent or can’t get an appointment with a doctor. The conversations always start with a basic question: “Tell me about yourself.” She wants to know her clients before she figures out how she can help. “Sometimes a patient just needs somebody to listen to them, so you just listen,” said Garfield, 52. (Cohen Marill, 2/8)
Also —
Wisconsin State Journal:
Tables Turned: Wisconsin Cardiologist Who Attended Johns Hopkins Medical School Gets Rare Heart-Kidney Transplant
Dr. Matt Wolff became a cardiologist, treating heart disease, before learning he has a genetic heart condition that can cause people to die suddenly as his father did at age 50. After spending years as UW Health’s chief of cardiology, replacing heart valves and doing angioplasties to clear blocked arteries, Wolff has undergone a major procedure himself: a heart-kidney transplant. (Wahlberg, 2/6)
Becker's Hospital Review:
CEO Gets 15 Years In Prison For $150M Healthcare Fraud
The CEO of a group of Texas-based hospice and home health companies was sentenced Feb. 3 to 15 years in prison for his role in a $150 million healthcare fraud and money laundering scheme, according to the Department of Justice. Henry McInnis was sentenced more than a year after he was convicted of conspiracy to commit healthcare fraud, conspiracy to commit money laundering, obstruction of justice and healthcare fraud. (Ellison, 2/5)
