Plus, Komodo Health banks $200M infusion

Editor's note: Fierce Healthcare Weekly Digest will be on a publishing break until Jan. 7. Stick with www.fiercehealthcare.com for breaking news until then. Happy holidays!

This Week

Dec 17, 2022

CMS proposes new Medicare Advantage and Part D reforms on prior authorization, marketing


Healthcare companies' default risk steadily rising, with most owned by private equity: Moody's


Komodo Health banks $200M equity infusion to fuel growth as it restructures, cuts headcount by 9%


Commonwealth Fund: COVID-19 vaccine prevented more than 18M hospitalizations, 3M deaths


Medly Health, owner of pharmacy startup, has filed for bankruptcy with plans to sell 22 stores. - Paige Minemyer

 

Featured

CMS proposes new Medicare Advantage and Part D reforms on prior authorization, marketing

CMS proposed new policies for Medicare Advantage and Part D plans, including streamlining prior authorization and adding a health equity index to star ratings.
 

Top Stories

Healthcare companies' default risk steadily rising, with most owned by private equity: Moody's

Amid a weakening macroeconomic environment and ongoing pressure by private and public payers to reduce healthcare costs, a growing number of healthcare companies are faced with credit rating downgrades and potential defaults.

Komodo Health banks $200M equity infusion to fuel growth as it restructures, cuts head count by 9%

Health data startup Komodo Health secured a structured equity infusion of $200 million in early November as it looks to continue scaling its data-driven "healthcare map" and analytics tools.

Commonwealth Fund: COVID-19 vaccine prevented more than 18M hospitalizations, 3M deaths

A new analysis found over the past two years the COVID-19 vaccine has prevented more than 18 million additional hospitalizations and 3 million additional deaths.

Medly Health, owner of pharmacy startup, has filed for bankruptcy with plans to sell 22 stores

Medly Health, parent company of a New York City-based digital pharmacy startup that took off during the COVID-19 pandemic, filed for Chapter 11 bankruptcy protection Friday.

Federal appeals court strikes down Biden admin's transgender care mandate

A federal appeals court ruled that the Biden administration cannot force religious healthcare providers to perform or pay for gender transition surgeries as it violates the religious rights of some Catholic organizations.

Bright Health at risk of being removed from NYSE

Bright Health's financial woes continue, and the company is now at risk of being pulled from the New York Stock Exchange.

CMS proposes cap on nonstandard ACA plans, network adequacy standard changes for 2024

CMS proposed a cap on the number of nonstandardized Affordable Care Act plans insurers can offer on HealthCare.gov and other updates to network adequacy standards.

Value-based payment system shortchanges PCPs, says study

Some primary care physicians who deliver quality care aren’t reimbursed for it because of flaws in the Medicare Merit-based Incentive Payment System (MIPS), according to a study.

Genetic testing lab owner convicted in $463M Medicare fraud case

In what the Department of Justice is calling one of the biggest healthcare fraud schemes ever, a federal grand jury convicted the owner of a genetic testing lab for cancer of bilking Medicare out of hundreds of millions of dollars.
 
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The Change Healthcare 2022 Revenue Cycle Denials Index

The Change Healthcare 2022 Revenue Cycle Denials Index provides a review of national medical claim denial trends, with strategies to help decrease denial rates.
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Humanizing Revenue Cycle Management

One sentence that will be displayed in the newsletter and should be written to grab the interest of your audience to want to read more.
 

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