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Brian Thompson, CEO of UnitedHealthcare, was fatally shot in New York as he headed to an investor conference. The police are searching for a suspect who checked into a hostel with a fake ID and was captured on security cameras. Investigators found bullet casings with messages related to insurance disputes, highlighting ongoing criticisms of the company for denying patient claims.
Anthem Blue Cross Blue Shield faced significant backlash over a proposed anesthesia policy that would limit payment for anesthesia services based on procedure duration. Following widespread criticism from anesthesiologists and state officials, Anthem has reversed the policy in Connecticut, New York, and Missouri, clarifying that it will continue to cover medically necessary anesthesia services. The American Society of Anesthesiologists condemned the policy as a harmful attempt to cut costs, raising concerns about patient care and financial burdens on providers.
UnitedHealthcare won a lawsuit against the Centers for Medicare and Medicaid Services (CMS), which requires the agency to recalculate the insurer's star ratings for 2025. A federal judge ruled that CMS violated the Administrative Procedure Act by incorrectly marking a test call as unsuccessful, impacting the ratings significantly. This decision could lead to increased quality bonus payments for UnitedHealthcare in 2026, as star ratings are crucial for enrollment and funding.
Mike Pykosz, the former CEO of Oak Street Health, is leaving CVS Health amid a leadership shakeup, with Sree Chaguturu, M.D., stepping in as president for healthcare delivery. Chaguturu, who also serves as chief medical officer, will oversee CVS" medical affairs and enhance patient care across its services. This transition comes as CVS navigates financial challenges and strengthens its healthcare delivery segment, which has seen significant growth in Aetna enrollments.
Orthopedic providers have filed a federal lawsuit against Elevance, UnitedHealthcare, and other insurers, alleging a multibillion-dollar price-fixing scheme with MultiPlan to suppress out-of-network payment rates to doctors. The complaint claims that insurers collectively outsource rate-setting to MultiPlan, violating antitrust laws, while MultiPlan"s algorithmic compensation determination is described as a facade for traditional price-fixing. The lawsuit seeks class action status, a jury trial, and a judgment declaring the conduct unlawful.
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Murder of UnitedHealthcare CEO Raises Questions About Insurance Disputes and Suspect
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11:25 06.12.2024
Anthem Reverses Anesthesia Policy After Backlash from Patients and Anesthesiologists
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insurers accused of price fixing in multibillion dollar lawsuit
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18:01 19.11.2024
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