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Highmark Sells Medicare Claims Business to Prevent Conflict of Interest
Highmark is selling its Medicare claims processing business to avoid any conflict-of-interest issues related to its purchase of West Penn Allegheny Health System (WPAHS). Blue Cross Blue Shield of Florida's subsidiary, Diversified Service Options, is buying Highmark Medicare Services (HMS) for an undisclosed sum.
"This change was prompted by Highmark's provider strategy," Highmark Vice President David O'Brien said in a statement. "The decision was a difficult one, but one which best positions HMS to maintain its current business and pursue its government business growth strategy."
HMS processes Medicare claims for the federal government in Pennsylvania, New Jersey, Maryland, Delaware and the District of Columbia. If Highmark didn't sell HMS, it would have owned a hospital that bills Medicare as well as a company that processes those claims, which violates federal requirements, reports the Pittsburgh Business Times.
Although HMS generated about $100 million in revenue, Highmark said selling the company won't impact the insurer's bottom line.
Read the full story at: http://tinyurl.com/7je67gb
To learn more:
Pittsburgh Business Times: http://tinyurl.com/6ql3djo
Pittsburgh Post-Gazette: http://tinyurl.com/7uy8vmd
Source: Fierce Health Payer
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Empowering Community Health Through Wellness and Faith
April 23rd 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In the third episode, Camille Clarke-Smith, EdD, MS, CHES, CPT, discusses approaching community health holistically through spiritual and community engagement.
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Insurance Coverage Limits JAKi Therapy Access for Patients With AA, Especially Non-White Populations
April 25th 2024A survey study showed major barriers to Janus kinase inhibitor (JAKi) therapy for patients with alopecia areata, especially for non-White patients who face higher rates of being uninsured and struggle more to afford the treatment.
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