This is Jacob Emerson with the Becker pair issues podcast. Here is your bi weekly industry news briefing for July first. Let's get to a... Slew of opt stories, A, and United Health Group have agreed to sell an unknown number of care centers to vital caring group. I made the company's planned Jurors later this year.
The company wrote Ae wrote in a June 20 eighth regulatory filing that cons confirmation of the dives sure is contingent on a number of conditions, including the confirmation of the previously announced murder transaction, Opt announced its intent to acquire a meta 3300000000.0 dollars back in June of 20 23. I'm mattis shareholders approved the deal in September, but it is currently under review by the
Justice department. Federal lawmakers have urged careful scrutiny of the deal and Oregon regulators have launched their own probe into the acquisition. In inmate the 2 companies reportedly offered to sell 100 clinics to a private equity buyer to make the deal more palatable to regulators. That merger is still expected to close in the second half of that this year. A meta provides home health care, hospice and pal care. It operates more than 500 clinics in 37
states. This Well, Opt has scrapped its plan to acquire Steward health physician group, stewardship Health. Opt, which has almost 90000 employed or affiliated physicians agreed on a preliminary deal in March to acquire the physician group, which comprises primary care physicians and other clinicians in 8 states. Stewart and Opt did not finalize an asset purchase agreement, and Opt is no longer pursuing
the acquisition. It is not clear whether Steward is negotiating with other potential Myers for the physician group, which it recently describes as a highly desired asset. It Steward filed for chapter 11 bankruptcy in May and is required to sell its assets, including 31 hospitals through auctions. While Opt will pay 20000000 dollars to settle allegations. It improperly dispensed some opioid medications. That's according to the justice department on June 20
seventh. That settlement resolves an investigation into whether Opt, yeah improperly filled justice certain opioid prescriptions between 20 13 and 20 15. The Doj alleged the pharmaceutical benefit manager improperly dispensed opioids in combination with other drugs, including benz and muscle relax from its mail order pharmacy operations in the San Diego area. Opioids prescribed along benz diaz and muscle relax are commonly referred to as Trinity
prescriptions. These prescriptions raise red flags the drugs may not be for legitimate medical use and could lead to the diversion of controlled substances. In the Doj investigation, the department, alleged Opt dispensed Trinity prescriptions without resolving red flags. Opt did not admit liability and as part of the settlement.
Well, Human man new president and Ceo, Jim Ra is is officially on the job, mister Ra joined Human anna as Ceo in January after serving as the ceo, Ceo of Envision healthcare since 20 20. He wrote on Linkedin on July first that the company has the opportunity to be the best integrated health care company in the United States. Human former Ceo Bruce Bro is resigning from Human board of directors and will serve as a strategic adviser to the company through 20 26.
Well Blue Cross and Blue Shield of Island is eliminating your leases 65 percent to prior authorization requirements for primary care providers by early 20 25. The pay of you data to identify some of the most common orders that create additional work for Pcp, radiology, and cardiology services led the list of requirements being cut, and the changes will apply
across commercial and Medicare plans. The company said they're hopeful that reducing these authors patients along with making significant investments in primary care practices will help Pcp thrive and improve patient access to care. The company as of removed, the company removed all prior authorization for outpatient behavioral services in
20 18. Other payers like United Health, ci Blue Cross of Michigan, 0.32 health and Ae, have all reduced prior authorization requirements over the last few years.
Will Albany New York based albany health system will no longer accept Human Medicare advantage plans for emergency services after June t. In February, a spokesperson for the health system cited administrative conflicts to local media outlets as the reason for the decision June They said patient care is the most important aspect of our mission, and we look for insurance partners who share our values of putting patients first.
When working with, insurance providers, we strive to ensure the terms are fair to us and fair to our patients. Albany mad operates 4 hospitals in the region and has 800 physicians and a hundred 25 facilities. In that same area, community care physicians, a multi specialty medical group went out of network with Human Medicare Advantage in March Cc has more than 1800 employees, including more than 420 clinicians across 70 practices in New York's Capital Reit.
Well Saint. Louis Based ascension will no longer offer individual health plans on the Texas Aca marketplace past 20 24, Individuals currently covered on the exchange by ascension personalized care in Texas will automatically be mapped to a similar insurance plan during the open enrollment period for 20 25 and should not experience a gap in coverage. That's according to a system spokesperson. Covered individuals may choose to sell select a different plan during the same time frame.
Ascension Aca plans are available in Indiana and Tennessee. The system setback in April is would also stop offering health plans on the Kansas exchange. And finally, sidecar car health and El California based payer that average Highs members paying providers cash prices has closed a 165000000 dollar series d financing round. That was led by Coke Disruptive technologies. Sidecar offers employer plans in Georgia and Ohio, and it said June 26, the new capital
will support expansion into Florida. The company also offers Aca coverage in 18 states. Coke industries has also selected sidecar to provide a portion of such employee health benefits starting in 20 25. If you like the latest health insurance industry news delivered straight your inbox every morning, subscribe to the pair issues, e newsletter on our websites at becker payer dot com. Becker