If a patient receives a continuous glucose monitor device through their medical benefit, they may be more adherent and may have lower costs, according to a new analysis. Researchers at CCS, which offers clinical services and home delivery for medical supplies for people with chronic conditions, published the peer-reviewed study this week in the Journal of Medical...

The Federal Trade Commission is suing the titans of the pharmacy benefit manager industry for anticompetitive practices and artificially raising the price of insulin drug prices, the agency announced Friday. The complaint alleges that Optum Rx, Express Scripts and Caremark—all vertically integrated with UnitedHealth Group, Cigna and CVS Health, respectively—caused patients to pay more for...

A new study suggests major pharmacy benefit managers may be focusing on specific payer segments in a bid to maintain strong market share. The analysis,releasedin the Journal of the American Medical Association, finds that CVS Health's Caremark holds the largest market share overall in the PBM space. However, it led by the largest margin Medicaid managed care, controlling 39.2% of the market.

CMS isnotifyingnearly a million Medicare beneficiaries of a data breach in which a hacker copied patients' files. The breach originated with Wisconsin Physicians Service Insurance Corp., an administrative services contractor for CMS that used the MOVEit file transfer software from Progress Software. MOVEit had asecurity vulnerabilityin 2023 that left its clients' data susceptible to...

The Department of Health and Human Services (HHS) is dropping its appeal of a June U.S. District Court ruling that vacated the government's restriction of third-party online tracking technologies on hospital webpages. The white flag came 10 days after the administration had filed its appeal to the Fifth Circuit. The casehad been brought in late 2023 by the American...

Hospitals across the U.S. are incorporating artificial intelligence into administrative and clinical workflows, testing the waters with one of the most disruptive forces in any industry today. C-suite leaders are gathering information and beginning to forge a plan for safely leveraging AI to its full potential, but the rapid pace of change means and increased costs of...

Nurses' satisfaction with EHRs is increasing, though challenges with reliability and response times remain opportunities for improvement, according to an Aug. 20 reportfrom KLAS Research. The report is based on insights from about 75,000 nurses regarding their EHR experience and satisfaction. KLAS collected the feedback through its Arch Collaborative EHR Experience Survey, conducted between 2021 and 2023, with a total of...

The Centers for Medicare & Medicaid Services (CMS) released a final procedural notice on Wednesday to expedite Medicare coverage of novel medical devices and get the devices to Medicare beneficiaries faster. The House Ways and Means Committee passed legislation in June that significantly diverges from thefinal notice. CMS proposed the Transitional Coverage for...

Artificial intelligence is often hailed as the solution to many of healthcare's pressing challenges, especially in the face of a growing workforce shortage. However, industry leaders caution against viewing AI as a quick fix. Health systems are still in the early stages of developing AI governance and integrating it safely into clinical and administrative functions. Over the next decade, AI could realize...

Lawmakers bashed the business practices of pharmacy benefit managers during a House Committee on Oversight and Accountability hearing Tuesday. When they were asked repeatedly about steering patients, increased drug prices and pharmacy closures, the company executives largely refuted claims thrown at them. The hearing coincided with the release of a new report (PDF) compiled by the committee...