Mercy, one of the largest health systems in Missouri, is threatening to stop accepting Anthem insurance unless an agreement on how much the insurer reimburses hospitals for care is reached by the end of the year. Chesterfield-based Mercy, which operates dozens of hospitals and hundreds of other outpatient locations in the region, has announced it intends to move out of the insurer's network in January if Anthem does not agree to a new contract. The contract sets the amount of money the insurer pays hospitals for surgeries, checkups and the thousands of other services the health system provides.
Walgreens has agreed to pay $106 million to settle lawsuits that alleged the pharmacy chain submitted false payment claims with government healthcare programs for prescriptions that were never dispensed. The settlement announced on Friday resolves lawsuits filed in New Mexico, Texas and Florida on behalf of three people who had worked in Walgreens' pharmacy operation. The pharmacy chain was accused of submitting false payment claims to Medicare, Medicaid and other federal healthcare programs between 2009 and 2020 for prescriptions that were processed but never picked up.
Elevance Health, the parent of more than a dozen state Blue Cross Blue Shield plans, is purchasing Indiana University Health's insurance business in a deal that would increase its dominance in several key cities in the state. IU Health's decision to sell is the latest and most prominent example of hospital systems giving up on the idea that they can be both a provider and payer of care. Financial terms of the deal weren't disclosed, and IU Health declined to answer questions from STAT.
A key Senate Republican dismissed the idea that the Affordable Care Act can be repealed next Congress, despite former President Trump's interest in the issue. If Republicans take control of the Senate after November's election, Sen. Bill Cassidy (R-La.) would likely be in charge of the Senate's health committee, which would share responsibility for changes to the ACA. He says any comprehensive healthcare reforms would have to be bipartisan, and noted that repealing the ACA would be a nonstarter among Democrats.
Essentia Health is dropping out of Medicare Advantage health insurance networks next year at UnitedHealthcare and Humana, moves that will impact about 14,000 seniors in Minnesota. The Duluth-based health system's announcement Tuesday makes it the third large nonprofit with Minnesota operations to recently say it will break future network ties with a Medicare Advantage health plan, all citing concerns about coverage denials and payment delays.
Stanislaus Surgical Hospital said Monday it will suspend operations indefinitely and lay off employees, due to a federal agency decision not to renew its provider agreement for serving Medicare and Medi-Cal patients. The temporary closure of the 23-bed hospital at Oakdale Road and Orangeburg Avenue is effective Saturday, a spokesperson said in a statement Monday. The CMS is terminating the provider agreement with Stanislaus Surgical effective Sept. 15 because the hospital is not in compliance with conditions of participation in the programs.