Healthcare Companies

It's never good for business when you've angered 900,000 doctors. But with any luck, that chapter is over for 23 Blue Cross and Blue Shield plans, which were targeted by a class-action lawsuit alleging unfair payment practices. The suit, which was filed in 2003, asserted that 23 BCBS plans were habitually cheating doctors by deliberately paying for less-intensive services than they had in fact provided. The BCBS plans have agreed to pay $128 million to settle the suit, and pay as much as …

This could be the final chapter in the convoluted legal troubles of HealthSouth founder Richard Scrushy. Scrushy has settled with the Securities and Exchange Commission in a suit resulting from a investigation of his role in the firm's $2.7 billion accounting fraud. The SEC suit asserted that Scrushy ordered executives to cook the books at HealthSouth when earnings were shaky. The now-notorious …

HealthSouth has agreed to sell its diagnostic division for $47.5 million, part of a long-term shift in its strategy which will focus the company on "post acute" care. The company is still recovering from the massive $2.7 billion accounting scandal, under which 15 executives were convicted of misconduct. The diagnostic division, which includes 54 freestanding diagnostic imaging centers in 19 states, …

A new study published in the Journal of the American Medical Association has concluded that patients in for-profit dialysis chains routinely get higher doses of the antianemia drug Epogen. These larger doses, while lucrative for the chains, can sometimes boost red blood cells above FDA levels. Part of the reason for the higher doses is financial. Medicare reimbursement encourages use of the drug, and clinics take in about 25 percent of their revenue through Epogen payments. …

Long-term care provider Genesis HealthCare is fighting to gain shareholder approval for a proposed buyout by investors, hoping to win shareholders back after an adverse recommendation by an advisory firm put the deal in doubt. Genesis, which operates more than 200 skilled nursing centers and assisted living residences in addition to providing contract rehab services to 600 providers, has been offered $63 per share by private equity firms Formation Capital and JER Partners. However, the …

With a new policy poised to take effect which would impose fines for out-of-network lab referrals, UnitedHealth Group has gone too far, doctors say. Late last year, UnitedHealth struck a 10-year deal with LabCorp making its locations the preferred in-network testing facilities for the health plan's 28.5 million members. While that didn't raise eyebrows, UnitedHealth's next step did. UHG has now warned doctors that if they referred to other labs frequently, it could potentially fine them …

A proposed merger between Pennsylvania-based health plans Independence Blue Cross and Highmark drew criticism yesterday, with politicians and consumer groups raising questions about the impact of the deal. The proposed merger, which has already been approved by the boards of the two plans, would create the nation's third-largest health insurer, with 9 million beneficiaries and more than …

WellPoint, by some measures the nation's largest health plan, has decided to take some aggressive steps to promote its new member health index (MHI). WellPoint has begun tying the index, a comprehensive measure of health improvement in its 34 million enrollees, directly to the compensation of every WellPoint employee. While it's increasingly common to compensate physicians for member health improvements, tying all employee bonuses to such a measure may be a first. The MHI includes 20 …

It looks like a bitter divorce for a group of hospitals seeking to leave a Cincinnati-based health system. Last year, three hospitals that made up part of the Health Alliance of Greater Cincinnati gave notice that they didn't want to be part of the Alliance anymore. The Health Alliance sued to stop the departing hospitals, which include Christ Hospital of Mount Auburn, Ohio and the two St. Luke Hospitals in northern Kentucky. The hospitals then countersued to get out of the pact. In its …

The Federal Trade Commission has asked for more information on a $120 million merger between a money-losing charity hospital and the University of Pittsburgh Medical Center (UPMC), slowing down what has already been a drawn-out process. Under the terms of the deal (which parties hoped would close last year), UPMC would take over Pittsburgh's Mercy Hospital. Mercy is not doing well on its own, having lost about $42 million over the past three years on its hospital and primary care …