- 5 state behavioral health policy updates
- Oregon’s anti-consolidation bill tested by physician contract switch-up
- Mass General Brigham, Dana-Farber to coordinate on split: Boston Globe
- How AI-enabled early detection is redefining preventive care
- Medical device maker Stryker hit with cyberattack
- New York university to launch dental school
- Aetna to pay $118M to resolve Medicare Advantage upcoding allegations
- Fraud lawsuits against Erlanger can proceed, judge rules
- Medical debt linked to deferred dental care: Study
- FDA launches single adverse event platform
- Riverside Health taps new system finance leader, hospital president
- Medicare beneficiaries may pay more amid insurer acquisitions of PBMs: Study
- Medicare beneficiaries may pay more amid insurer acquisitions of PBMs: Study
- Virginia Mason Franciscan exec heads to Providence
- IU Health bets on ‘big, one-time endeavors’ for the future
- IU Health bets on ‘big, one-time endeavors’ for the future
- Atrium Health Wake Forest Baptist taps hospital president
- ADHA targets professional autonomy in new strategic plan: 5 notes
- Duke University Health System files CON for $6.4M ASC
- Ohio dental practice to permanently close
- 3 health systems outsourcing RCM functions
- A flurry of noncompete updates in Q1
- Specialty1 Partners continues 2026 growth with new joint venture
- The CMS loophole shrinking ASC access: Inside ASCA advocacy
- CMS imposes equipment supplier moratorium; 3 sentenced to prison in fraud cases
- Guidelight names chief growth officer
- ‘A delta in opportunity’: The savings independent ASCs are leaving on the table
- Despite insurers' expense pains, Tenet Healthcare is securing healthy commercial rates through 2027
- Nebraska Medicine’s $99.3M center to expand behavioral health services
- FDA approves 1st treatment for cerebral folate deficiency tied to autistic features
- 8 health system rating downgrades
- The looming impact of site-neutral payments on ASCs
- Dental industry headed for consolidation shift amid DSO financial woes: 4 notes
- Why this anesthesia leader says stipends are here to stay
- Northwestern Medicine opens expanded outpatient center
- Meet the ASC industry’s ‘alternative to the traditional MSO’
- University of Minnesota dental clinic closes over financial challenges
- Study Links State Taxes to COVID Lockdown Decisions
- Hospital expenses grew twice as fast as prices in 2025: 4 AHA findings
- Aetna to pay $117.7M to settle Medicare Advantage upcoding allegations: DOJ
- Connecticut fines debt collector $100K for calls to hospital emergency line
- ADA names Dr. Nader Nadershahi as executive director
- Connecticut health system strikes RCM partnership
- Stryker hit by international cyberattack linked to pro-Iran group
- AHA: Hospitals' total expenses rose by 7.5% in 2025
- AstraZeneca recruits Joshua Jackson, Philadelphia Flyers’ Gritty to cancer screening push
- As Lilly flourishes in Q4, peer projections signal looming sector slowdown in 2026
- FDA May Allow Some Flavored Vapes Aimed at Adults
- Dark Sweet Cherries May Help Slow Aggressive Breast Cancer, Mouse Study Suggests
- FDA Approves Leucovorin for Rare Brain Disorder, Not Autism
- Joint Economic Committee report: Medicare Advantage overpayments drive up Part B premiums
- Veeva shells out $100M for Ostro and its AI chat tool for pharma brand engagement
- Lilly beefs up oral GLP-1 capacity with $3B manufacturing pledge in China
- UCB's Bimzelx continues winning streak with victory over AbbVie's Skyrizi
- Lowering Parents' Stress Can Reduce Risk Of Childhood Obesity
- Multilingualism Might Not Aid Brain Aging, Researcher Argues
- 15-Year Study Shows Sharp Rise in Depression Among U.S. College Students
- Repealing Motorcycle Helmet Laws Leads to More Severe Crashes, Millions in Added Treatment Costs
- Why Childhood Cavities May Predict Adult Heart Disease
- Physical Therapy Costs Vary Widely In U.S., Study Finds
- J&J's Joaquin Duato joins $30M CEO pay club with 30% compensation boost for 2025
- Cosmetic Surgery Investigation Prompts Warnings for Patients, and a Push for Tighter Safety Standards
- Primary Care Is in Trouble. So Doctors Band Together To Boost Their Market Power.
- Skyhawk taps Teva alum to steer commercial path, while Santhera names new CCO to grow DMD sales
- Driving the news at HIMSS26: Verily, Samsung ink collaboration; Meditech's latest AI solutions
- Minnesota to give $5M in restitution to patients of shuttered dental office
- Colorado hospitals, advocates launch youth mental health coalition
- Pennsylvania hospital CFO on life after bankruptcy: ‘You’ve got to hold the line’
- Medicare allegedly paid $15M+ for ED services tied to non-ED sites: Report
- Climate warming could increase anxiety, depression: Study
- Sutter Health boosts operating margin to 2.6% in 2025
- Remarks at the Institute of International Bankers 2026 Annual Washington Conference
- Fostering Regulatory Harmony Between the SEC and CFTC
- Only 4 states satisfy over 50% of mental health workforce needs: Report
- Here's where hospital markets are the most concentrated
- A look at how CVS is leaning on 'agentic twins' in developing consumer tech
- Bancos, primera línea de batalla contra los fraudes financieros a adultos mayores
- Inside Grand Mental Health’s tech-enabled crisis response model
- Sandoz to set up standalone biosimilars unit as it eyes upcoming 'golden decade' of patent losses
- Indiana syringe services face ID requirement, restrictions
- AbbVie's Robert Michael earns hefty pay bump to $32.5M in 2nd year as CEO
- NYU Stern report calls for private equity reforms to safeguard quality of care
- Remarks at the International Bar Association’s 24th Annual International Conference on Private Investment Funds
- Raw Oysters and Clams Recalled After Norovirus-Like Illness Outbreak in Washington
- Mammograms May Also Reveal Hidden Heart Disease Risk, Study Finds
- Chile Becomes First Country in the Americas To Eliminate Leprosy
- Going Abroad? CDC Warns Travelers About Polio Risk in Several Countries
- Listen to the Latest ‘KFF Health News Minute’
- The Fierce Healthcare team on the Fierce 15 of 2026
- Más niños llegan a salas de emergencias con dolor de muelas. Los recortes de Trump y la lucha anti flúor de RFK Jr. no ayudan
- Centene's stock falls as CEO London outlines ongoing ACA headwinds
- AI-fueled misdiagnoses, rural care barriers are 2026's top patient safety threats: ECRI
- Patients want price transparency, e-commerce experience from pharma DTP platforms: survey
- Carrum Health teams up with Virta Health on a comprehensive weight loss solution
- Leerink questions whether BioNTech can thrive without their 'founders' insight' as stock drops
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- Approved IV Drug, Gazvya, Reduces Lupus Symptoms, Clinical Trial Finds
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- More Kids Are in ERs for Tooth Pain. Trump Cuts and RFK Jr.’s Anti-Fluoride Fight Aren’t Helping.
- FDA approves leucovorin for ultrarare cerebral folate deficiency subset without clinical trial
- BioNTech's CEO, CMO prep departure to set up next-gen mRNA company
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- Healthcare Dealmakers—Hims & Hers goes international with Eucalyptus purchase, Humana's CenterWell buys MaxHealth and more
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- Community Health System selling 4 Arkansas hospitals to Freeman Health System for $112M
- Philips unveils Rembra CT for acute and high-demand imaging environments
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Medicaid covers approximately 22% of Michiganders:
https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2023/08/22/mihealthylife
MDHHS moving forward with MIHealthy Life to provide improved access to care for Medicaid health plan enrollees
By Lynn Sutfin - August 22, 2023
Department rebidding contracts that serve 2.2 million Michiganders
LANSING, Mich. – The Michigan Department of Health and Human Services (MDHHS) today provided new information related to the rebidding of contracts for health plans that provide services to 2.2 million Michiganders receiving coverage through Medicaid and Michigan’s Healthy Michigan Plan.
MDHHS is announcing network requirements and minimum qualifications for bidders in its upcoming request for proposals for the Comprehensive Health Care Program contract for Michigan’s Medicaid health plans.
“We want to provide Michiganders served by Medicaid health plans with a more equitable, coordinated and person-centered system of care,” said Elizabeth Hertel, MDHHS director. “Through this rebid process, MDHHS seeks to provide improved affordable health care coverage for Michiganders served by Medicaid health plans.”
The contract is being rebid during fiscal year 2024, which begins Oct. 1, with new contracts beginning in fiscal year 2025. The rebid is part of MIHealthyLife, an initiative to strengthen Medicaid services informed by input from nearly 10,000 enrollees and family members, health care providers, health plans and other community partners.
Consistent with federal standards and input from MIHealthyLife stakeholders, the rebid will include updates to Michigan’s Medicaid Health Plan network adequacy and timely access standards, which can be found at Michigan.gov/MDHHS/MIHealthyLife.
When determining whether these standards are met, MDHHS will only consider providers with whom bidders have executed contracts at the time of bid submission. MDHHS is releasing its updates to Comprehensive Health Care Program network adequacy and timely access standards in advance of the rebid to provide time for potential bidders to review their provider networks and execute provider contracts necessary to meet the new standards.
MDHHS’s new Medicaid Health plan network adequacy and timely access standards can be found at Michigan.gov/MDHHS/MIHealthyLife, along with mandatory minimum requirements Medicaid Health Plans must meet in order to qualify for review under the rebid.
In addition, the request for proposals will incorporate several Comprehensive Health Care Program changes intended to advance the MIHealthyLife pillars. These include:
- A commitment to health equity demonstrated by plans achieving the NCQA’s Health Equity Accreditation, beginning the process no later than Oct. 1, 2024.
- A strong emphasis on addressing social determinants of health demonstrated by investment and engagement with community-based organizations.
- Efforts to increase childhood vaccination rates, including increasing provider participation in the Vaccines for Children Program.
- Adoption over time of a more person-centered approach to mental health care coverage.
The Medicaid Health Plan request for proposals will be posted to the SIGMA system in Fall 2023, with responses due in January 2024. New contracts resulting from this rebid are scheduled to begin on Oct. 1, 2024. MDHHS reserves the right to change mandatory minimum requirements, dates or any other information deemed necessary.
Go to Michigan.gov/MDHHS/MIHealthyLife for more information. Questions about MIHealthyLife can be sent to mdhhs-mihealthylife@michigan.gov. Procurement-related questions can be sent to Samuelb@michigan.gov.
Will the rebidding prevent $ 500 million Medicaid frauds like this?
Metro Detroit doctor to pay $6.5M over fraud health care fraud claims
Charles E. Ramirez - August 29, 2023A Metro Detroit doctor and his three Macomb County pain management clinics have agreed to pay $6.5 million over claims he scammed the federal government, officials said.
Rajendra Bothra and his businesses, the Pain Center USA PLLC and Interventional Pain Center PLLC, agreed to the settlement to resolve allegations that they billed Medicare and Medicaid for unnecessary treatments, drug tests and braces, federal officials announced Monday.
"When healthcare providers manipulate the Medicaid and Medicare systems, it wastes resources meant to help those in need," Devin Kowalski, Acting Special Agent in Charge of the FBI’s Detroit Field Office, said in a statement. "This settlement brings to bear some economic justice by requiring those who orchestrated the fraud scheme to pay for their actions."
The alleged fraud took place between Jan. 1, 2015, and Dec. 31, 2018, said Dawn Ison, U.S. Attorney for the Eastern District of Michigan.
Bothra and federal authorities are not strangers to each other.
In 2018, federal officials indicted Bothra and five other doctors who worked for him at his clinics on charges they cheated Medicare and Medicaid out of almost $500 million by illegally prescribing more than 13 million doses of prescription pain medication.
They also alleged the doctors forced patients to undergo painful, unnecessary or ineligible medical procedures in exchange for illegally receiving pain medication, including OxyContin, Vicodin, hydrocodone and Percocet.
Investigators said the operation was run at the Pain Center USA clinics in Warren and Eastpointe as well as the Interventional Pain Center clinic in Warren.
Bothra, once a renowned surgeon, humanitarian and politician who was given India’s highest civilian honor, maintained his innocence but spent three years in federal prison as the COVID-19 pandemic delayed his trial.
In June 2022, a jury acquitted him and three of his former employees of the charges. Two other doctors who were charged took plea deals.
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