Legal / Regulatory / Risk Management

Latest Headlines

Latest Headlines

Anthem-Cigna discord compounds uncertainty over merger's future

Reports of behind-the-scenes bickering between Anthem and Cigna have reverberated in the stock market and raised further doubts about the likelihood the health insurers' merger will win approval.  

Massachusetts ballot proposition to equalize hospital payments could be disastrous

A union-backed ballot initiative to equalize payments to hospitals in Massachusetts is raising significant concerns both within and outside the provider community. If passed by voters later this year, no hospital would be paid more than 20 percent above the statewide average for any medical procedure, according to  The Boston Globe.

System provides doctors with instant drug history information

Doctors cite myriad reasons for not taking advantage of state prescription drug databases, even though health officials encourage the use of such tools more than ever in light of the country's opioid crisis.  

Keep proposed MACRA changes in perspective

Worries over the consequences of value-based payment methodologies in the Medicare Access and CHIP Reauthorization Act obscure significant improvements the rule makes over the status quo, writes Bob Doherty, senior vice president of Government Affairs and Public Policy at the American College of Physicians, in an article published in  MedPage Today.

Anthem, Cigna squabbles could threaten proposed merger

Tensions are rising between potential merger partners Anthem and Cigna, which could only make it more difficult for the two health insurance companies to win over federal regulators.  

Google kidney app pilot moves forward despite regulatory spotlight

A pilot of a Google DeepMind kidney monitoring app with the National Health Service Royal Free Trust is moving forward despite reports it was halted now that it's fallen under regulatory scrutiny.

Highmark's risk corridor litigation: Other insurers could follow suit

After Highmark sued the federal government for $224 million in unreimbursed losses from its Affordable Care Act policies, there are signs other insurers may consider filing similar suits.  

Healthcare device data thefts focus of federal court case

A 12-count indictment against an engineer illustrates more needs to be done to protect and store healthcare data.

With end of ICD-10 grace period looming, docs must be mindful of code specificity

As the end of the first year under ICD-10 fast approaches, physicians who filed claims under the Medicare Part B physician fee schedule must be mindful that the end one-year grace period from post-payment reviews also looms.

House bill would factor socioeconomic factors into readmission penalties

A bipartisan bill introduced in Congress this week would amend the Centers for Medicare & Medicaid Services' readmissions program to factor in patients' socioeconomic status to prevent hospitals from receiving penalties for circumstances beyond their control.