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Wednesday, Jun 5 2024

Full Issue

Judge Rules CMS Miscalculated Medicare Star Rating for SCAN Health

SCAN Health Plan had sued CMS, saying regulators didn't properly calculate the insurer's Medicare Advantage rating. The decision could have industrywide implications, Modern Healthcare says.

SCAN Health Plan has prevailed in a widely watched federal lawsuit brought last year against the聽Centers for Medicare and Medicaid Services that alleged regulators did not appropriately聽calculate the insurer's Medicare Advantage star rating. Judge Carl J. Nichols, of the U.S. District Court for the District of Columbia, on Monday sided with SCAN and wrote that regulators violated the Administrative Procedure Act when calculating the company鈥檚 star ratings scores last year. (Tepper, 6/4)

Ascension said Tuesday it expects to restore electronic health records by June 14, a little more than a month after the nonprofit system reported a cyberattack. Ascension has already restored health records in Florida and Alabama, plus the Austin market, according to a Tuesday news release. Clinicians will be able to access health records as before, the release said. (Hudson, 6/4)

The American Medical Association said it is considering filing a class action lawsuit against UnitedHealth Group and its Optum and Change Healthcare subsidiaries following the latter's data breach in February.聽The organization said Optum and Change Healthcare, which processed about 50% of all medical claims as of March, allegedly received unjust enrichment by continuing to collect premiums while the breach caused cash flow issues and care interruptions for many providers across the country. (DeSilva, 6/4)

Challenges providing care for nursing home patients with mental health and behavioral health issues are adding to聽discharge bottlenecks聽for hospitals, and the demand for such care has led some facilities to set up specialized units with additional staff just for those patients. Older adults are suffering from higher rates of mental health and behavioral health problems, which can complicate their recovery from surgery or illness. (Eastabrook, 6/4)

吃瓜不打烊: Health Worker For A Nonprofit? The New Ban On Noncompete Contracts May Not Help You

Many physicians and nurses are happy about the Federal Trade Commission鈥檚 new rule banning the use of noncompete agreements in employment contracts. But they are disappointed that it may not protect those who work for nonprofit hospitals and health care facilities, which provide most of the nation鈥檚 care and employ the largest number of medical professionals. (Meyer, 6/5)

吃瓜不打烊: End Of Pandemic Internet Subsidies Threatens A Health Care Lifeline For Rural America

Myrna Broncho realized just how necessary an internet connection can be after she broke her leg. In fall 2021, the 69-year-old climbed a ladder to the top of a shed in her pasture. The roof that protects her horses and cows needed to be fixed. So, drill in hand, she pushed down. That鈥檚 when she slipped. (Tribble, 6/5)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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