Plus, 2 Methodist Health System employees killed in shooting

This Week

Oct 29, 2022

CMS to restrict Medicare Advantage TV ads, scrutinize brokers and agents amid high complaints

2 Methodist Health System employees killed in maternity ward shooting

Centene bids adieu to Caremark, awards $35B PBM contract to Express Scripts. - Robert King

 

Featured

CMS to restrict Medicare Advantage TV ads, scrutinize brokers and agents amid high complaints

CMS is cracking down on Medicare Advantage marketing practices, including implementing a new requirement next year for federal approval of an TV ads before they air.
 

Top Stories

2 Methodist Health System employees killed in maternity ward shooting

The suspect was on parole for aggravated robbery and was permitted to visit the hospital with an ankle bracelet as his girlfriend gave birth, according to the Dallas Police Department.

Centene bids adieu to Caremark, awards $35B PBM contract to Express Scripts

Centene brought in $738 million in profit for the third quarter, surpassing Wall Street analysts' predictions.

Highmark steps up coverage of prescription digital therapies as companies see momentum in the payer market

Pittsburgh-based Highmark plans to expand insurance coverage for some prescription digital therapeutics cleared by the Food and Drug Administration, marking a major step forward for app makers in the market.

JPMorgan Chase teams with Vera Whole Health to open primary care clinics for employees

JPMorgan Chase is jumping into primary care and is piloting office-based clinics for employees in the Columbus, Ohio area.

These 3 drugs are set for FDA determinations soon. Here's why Optum says payers should take notice

Another gene therapy product is set for an FDA determination in short order, and this trend should make payers stand up and pay attention, according to experts at Optum.

Alife launches AI technology to advance IVF treatment outcomes, lower costs

After two years of R&D, startup Alife launched new artificial intelligence software to help fertility clinics optimize and support clinical decision-making during critical stages of the IVF process.

23andMe betting big on its genomic health service that integrates genetics with primary care

23andMe is focused on using Lemonaid Health's virtual care and online pharmacy capabilities to build out genetically-driven telehealth and pharmacogenomic services.

Are most Medicare Advantage plans really 'above average'? Experts question rating system CMS uses for MA

Nearly 70% of Medicare beneficiaries will be covered by Medicare Advantage plans by 2030, according to MedPAC. Experts question whether the star rating system used by the MA Quality Bonus Program needs to be upgraded.

Universal Health Services sees dipping profits despite halving contract labor costs from previous quarter

The acute and behavioral care company said its operations are still feeling the sting of COVID-19 and labor shortages.
 
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'Podnosis': Medicare Advantage and what you missed from the Fierce Health Payer summit

This week on "Podnosis," we talk about how MA plans are rethinking their sales pitch. We also eavesdrop on a panel discussion at the Fierce Health Payer summit on how payers are looking to address social determinants of health.
 

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