NEW YORK (Reuters)—U.S. antitrust officials on Thursday moved to block an unprecedented consolidation of the national health insurance market, filing suit against Anthem Inc.’s proposed purchase of Cigna Corp. and Aetna Inc.’s planned acquisition of Humana Inc. The U.S. Department of Justice (DOJ) says the two mergers would reduce competition, raise prices for consumers and…
U.S. Antitrust Officials Poised to Block Anthem, Aetna Deals
NEW YORK (Reuters)—U.S. antitrust officials are poised to file lawsuits to block Anthem Inc’s acquisition of Cigna Corp., as well as Aetna Inc.’s takeover of Humana Inc., a person familiar with the matter tells Reuters. Antitrust regulators have been scrutinizing the deals and looking at the potential for higher prices if the insurance market consolidates…
Practicing Telemedicine Raises Legal Considerations for Rheumatologists
With the evolution and advancement of technology, it was only a matter of time before such changes affected the medical industry. Although the concept of telemedicine dates back more than 50 years, emphasis on cost-effective quality healthcare coupled with technological advancements has caused a resurgence of telemedicine in recent years. What constitutes telemedicine largely depends…
U.S. Justice Department Has Concerns about Aetna-Humana Deal
(Reuters)—The U.S. Department of Justice has significant concerns about Aetna Inc.’s proposed acquisition of health insurer Humana Inc., a source familiar with the situation said on Thursday, and shares of Humana fell more than 11%. Aetna’s purchase of Humana would combine two of the largest providers of Medicare Advantage plans for elderly people, and investors…
California Insurance Commissioner Urges U.S. to Block Anthem-Cigna Deal
(Reuters)—California’s insurance commissioner on Thursday urged the U.S. Department of Justice (DOJ) to block health insurer Anthem Inc.’s acquisition of Cigna Corp., saying he is concerned it will raise premiums in the state. Dave Jones, who as insurance commissioner in California does not have authority to approve the deal, says he believes his recommendation will…
Doubts Mount over Merger of Health Insurers Anthem, Cigna
(Reuters)—Wall Street expressed growing doubts about a pending $54 billion merger of U.S. health insurers Anthem Inc. and Cigna Corp. on Monday as news of management squabbles added to concerns over its review by antitrust regulators. Cigna shares closed down 4% at $126.15, well below Anthem’s original $188 per share offer of cash and stock…
Preparing for Increased HIPAA Audits Among Smaller Rheumatology Providers
Recent enforcement activities of the Department of Health and Human Services’ Office for Civil Rights (OCR) have shown an increase in fines and penalties assessed against smaller providers for failing to comply with the privacy, security and breach notification requirements of the Health Insurance Portability and Accountability Act (HIPAA). Historically, OCR has focused on larger…
What Rheumatologists Need to Know about Payer Audits
Both government and private payers continue to aggressively monitor providers to prevent and recover overpayments. This is evidenced by the fact that the number of audits conducted in recent years has increased dramatically. A negative audit finding can result in the need to repay five- or seven-figure amounts. Types of Audits Private Payer Audits Private…
U.S. Hospital Group Warns of Blue Cross Dominance if Anthem Buys Cigna
(Reuters)—The American Hospital Association warned U.S. antitrust regulators that Anthem Inc.’s proposed acquisition of Cigna Corp. will hurt other health insurers’ ability to compete with Blue Cross Blue Shield plans, leading to higher premiums for consumers. Anthem, the country’s second-largest health insurer, runs Blue Cross Blue Shield plans in 14 states. The hospital group, in…
Los Angeles Hospital Paid Hackers $17,000 Ransom in Bitcoins
(Reuters)—The president of Hollywood Presbyterian Medical Center said on Wednesday that his hospital paid hackers a ransom of $17,000 in bitcoins to regain control of their computer systems after a cyber attack. Allen Stefanek said in a statement that paying the ransom was the “quickest and most efficient way” of regaining access to the affected…
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