This is Jacob Emerson with the Becker pair
issues podcast.
Here is your bi weekly industry news briefing
for July first. Let's get to a... Slew
of opt stories, A, and United Health Group
have agreed to sell an unknown number of
care centers to vital caring group. I made
the company's planned Jurors later this year.
The company wrote Ae wrote in a June
20 eighth regulatory filing that cons confirmation of
the dives sure is contingent on a number
of conditions, including the confirmation of the previously
announced murder transaction, Opt announced its intent to
acquire a meta
3300000000.0
dollars back in June of 20 23.
I'm mattis shareholders approved the deal in September,
but it is currently under review by the
Justice department. Federal lawmakers have urged careful scrutiny
of the deal and Oregon regulators have launched
their own probe into the acquisition. In inmate
the 2 companies reportedly offered to sell 100
clinics to a private equity buyer to make
the deal more palatable to regulators.
That merger is still expected to close in
the second half of that this year. A
meta provides home health care, hospice and pal
care. It operates more than 500 clinics in
37
states. This
Well, Opt has scrapped its plan to acquire
Steward health
physician group,
stewardship Health. Opt, which has almost 90000
employed or affiliated physicians agreed on a preliminary
deal in March to acquire the physician group,
which comprises primary care physicians and other clinicians
in 8 states.
Stewart and Opt did not finalize an asset
purchase agreement, and Opt is no longer pursuing
the acquisition. It is not clear whether Steward
is negotiating with other potential Myers for the
physician group, which it recently describes as a
highly desired asset. It Steward filed for chapter
11 bankruptcy in May and is required to
sell its assets, including 31 hospitals
through auctions.
While Opt will pay 20000000 dollars to settle
allegations. It improperly dispensed some opioid medications. That's
according to the justice department on June 20
seventh. That settlement resolves an investigation into whether
Opt,
yeah improperly filled justice certain opioid prescriptions between
20 13 and 20 15. The Doj alleged
the pharmaceutical
benefit manager improperly dispensed opioids in combination with
other drugs,
including benz
and muscle relax from its mail order pharmacy
operations in the San Diego area.
Opioids prescribed along benz diaz and muscle relax
are commonly referred to as Trinity
prescriptions. These prescriptions raise red flags the drugs
may not be for legitimate medical use and
could lead to the diversion of controlled substances.
In the Doj
investigation, the department, alleged Opt
dispensed Trinity prescriptions without resolving red flags.
Opt
did not admit liability and as part of
the settlement.
Well, Human man new president and Ceo, Jim
Ra is is officially on the job, mister
Ra joined Human anna as Ceo in January
after serving as the ceo,
Ceo of Envision healthcare since 20 20.
He wrote on Linkedin on July first that
the company has the opportunity to be the
best integrated health care company in the United
States. Human former Ceo Bruce Bro is resigning
from Human board of directors and will serve
as a strategic adviser to the company through
20 26.
Well Blue Cross and Blue Shield of Island
is eliminating your leases 65 percent to prior
authorization requirements for primary care providers by early
20 25.
The pay of you data to identify some
of the most common orders that create additional
work for Pcp,
radiology, and cardiology services led the list of
requirements being cut, and the changes will apply
across commercial and Medicare plans. The company said
they're hopeful that reducing these authors patients along
with making significant investments in primary care practices
will help Pcp thrive and improve patient access
to care.
The company as of removed, the company removed
all prior authorization for outpatient behavioral services in
20 18. Other payers like United Health, ci
Blue Cross of Michigan, 0.32 health and Ae,
have all reduced prior authorization requirements over the
last few years.
Will Albany New York
based albany health system will no longer accept
Human Medicare advantage plans for emergency services after
June t. In February, a spokesperson for the
health system cited administrative conflicts
to local media outlets as the reason for
the decision June They said patient care is
the most important aspect of our mission, and
we look for insurance partners who share our
values of putting patients first.
When working with, insurance providers, we strive to
ensure the terms are fair to us and
fair to our patients.
Albany mad operates 4 hospitals in the region
and has 800 physicians and a hundred 25
facilities. In that same area, community care physicians,
a multi specialty medical group went out of
network with Human Medicare Advantage in March
Cc has more than 1800 employees, including more
than 420
clinicians across 70 practices
in New York's Capital Reit.
Well Saint. Louis Based ascension will no longer
offer individual health plans on the Texas Aca
marketplace past 20 24,
Individuals currently covered on the exchange by ascension
personalized care in Texas will automatically be mapped
to a similar insurance plan during the open
enrollment period for 20 25 and should not
experience a gap in coverage. That's according to
a system spokesperson.
Covered individuals may choose to sell select a
different plan during the same time frame.
Ascension Aca plans are available in Indiana and
Tennessee.
The system setback in April is would also
stop offering health plans on the Kansas exchange.
And finally, sidecar car health and El California
based payer that average Highs members paying providers
cash prices
has closed a 165000000
dollar series d financing round. That was led
by Coke Disruptive technologies.
Sidecar offers employer plans in Georgia and Ohio,
and it said June 26, the new capital
will support expansion into Florida. The company also
offers Aca coverage in 18 states. Coke industries
has also selected sidecar to provide a portion
of such employee health benefits
starting in 20 25.
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