An investigation by the Drug Enforcement Administration led to allegations that the company filled prescriptions when prescribers did not possess proper state licensing while others exceeded the 90-day supply limits.
Blue Cross Blue Shield of Massachusetts wants to use value-based payment to address racial and ethnic health disparities and has already signed up hospitals including Mass General Brigham and Boston Medical Center.
The Centers for Medicare and Medicaid Services seeks to update regulations governing the Affordable Care Act's health insurance exchange marketplaces, including setting stricter standards for network adequacy, limiting non-standard plans and modifying the risk-adjustment methodology.
"Healthcare organizations had to learn to adapt and be resilient in the face of resource shortages and to meet shifts in consumer behavior and expectations," said Maria Morales Menendez, chief operating officer at Delray Medical Center.
Nearly a third of Medicaid disproportionate-share hospital payments in 2015 went to hospitals that provided less uncompensated care than the median level in their respective states, according to a study published Monday in Health Affairs.