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PBM clawbacks sidestep state bans on spread pricing | CMS drops payment rule | A hot market for M&A action

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Friday, October 29, 2021
Friday, October 29, 2021
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PBM clawbacks sidestep state bans on spread pricing

PBMs have found other ways to game Medicaid reimbursements in Ohio and elsewhere, experts say.

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Medicare issues ESRD rule with equity in mind

CMS's latest iteration of the end-stage renal disease payment model addresses health disparities for the first time.

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Medicaid insurance

Medicaid issues, not Medicare's, get fixes in Biden budget

The budget blueprint Biden released would fulfill a campaign promise to help poor people locked out of Medicaid expansion across the South due to partisan battles.

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Texas docs sue HHS over surprise billing rule

The Texas Medical Association argues the surprise billing regulation unfairly favors insurers.

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AIDS Healthcare Foundation intervenes in CVS class-action

At least five patients allege CVS's requirement that all customers receive prescriptions from a CVS mail-order pharmacy or retail pharmacist threatens their health and privacy.

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M&A action is about to go viral in Chicago hospital biz

The breakup of Amita Health will spark a new round of dealmaking: “This puts two M&A targets back out into the field.”

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Former Spokane Co. health officer files $1.4 million claim over firing

The former Spokane County health officer who believes he was fired last year due to unpopular decisions he made to try to contain COVID-19 has filed a claim with the health district, which could lead to a lawsuit.

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