Where DFW’s Healthcare Community Stands On A Price Transparency Proposal From CMS

Ask a random selection of people about whether they’d appreciate more up-front knowledge about the prices they pay for healthcare, and you’d be hard-pressed to find anyone that’s happy flailing around in the dark. As the public becomes more aware of inflated costs, the drumbeat for price transparency grows louder. But even so, practicality issues abound in transitioning a market whose prices have long sat largely beyond consumer view. As a result, the Centers for Medicare and Medicaid Services have proposed a rule that would force hospitals to post their lists of standard charges on their websites. At a minimum,… Full Story

Second Person Pleads Guilty In Massive Frisco Fraud Scheme In Which CEO Allegedly Accelerated Patient Deaths

Two people have now pled guilty in a fraud scheme involving a major North Texas hospice provider. Jessica Love became the second when she entered a plea this week in U.S. District Court in Dallas. The February 2017 indictment alleges Love and 15 others engaged in a $60 million scheme under Novus Health Services and Optim Health Services, which were effectively run as one entity known as Novus. Love, a 38-year-old registered nurse manager and regional director at Novus, participated via recruiting doctors to a kickback scheme, arranging kickback payments to assisted living facilities, falsifying documents, and collecting unused medications… Full Story

No Surprise Here: Texans’ No. 1 Health Policy Priority Is Lower Cost

Texans’ number one priority when it comes to health policy issues is lowering the amount that individuals pay for healthcare. That’s according to a statewide survey out Thursday from the Kaiser Family Foundation/Episcopal Health Foundation. Of those polled, 61 percent marked that option as a “top priority” while an additional 28 percent called it “important but not a top priority.” Just beyond that: Reducing the number of women who die from causes related to pregnancy and childbirth (59% top priority/30% important but not top priority), lowering the cost of prescription drugs (56%/32%), increasing access to health insurance (55%/32%), and increasing… Full Story

BCBSTX Agrees To 60-Day Delay In Implementing New ER Claims Policy

The Texas Department of Insurance has coaxed Blue Cross Blue Shield of Texas into a 60-day delay in implementing a policy that could leave some members on the hook for their entire emergency room bills. TDI Commissioner Kent Sullivan met with BCBSTX President Dr. Dan McCoy on Tuesday—with other representatives from both sides also in on the meeting—to discuss the new rules, according to a spokesperson for TDI. The department on Thursday sent a letter requesting more information on the change. BCBSTX notified members in April that HMO members visiting out-of-network ERs could be on the hook for their entire… Full Story

Dallas-based Health Insurance Company For Senior Market Grows Through Acquisition

Dallas-based Integrity Marketing Group has acquired part of a Cincinnati-based agency, expanding its presence in the Midwest and piling another 2018 deal onto its growing stack of them. The company, a national distributor of life and health insurance products for seniors, announced that it has acquired the senior market division of Cornerstone Broker Insurance Services Agency. Cornerstone serves Ohio and the surrounding states, and helped more than 30,000 seniors enroll in Medicare-related plans last year. Terms of the deal weren’t disclosed. Integrity has been busy this year. Earlier this month, it announced an acquisition of GoldenCare USA, a national wholesaler… Full Story

UnitedHealthcare North Texas Snags Former BCBSTX Chief of Staff

United Healthcare North Texas has a new vice president of network management, who came over after serving in various high-up roles at Blue Cross Blue Shield of Texas. JJ White is the new hire. She did her undergrad at the University of North Texas. At BCBSTX, White was most recently a divisional vice president for network innovation & strategy, and she served as chief of staff prior to that. She’d been with Blue Cross in one capacity or another since the mid-1990s. White started at UnitedHealthcare in April.

Blue Cross Blue Shield of Texas Becomes the Latest To Target Non-Emergency ER Visits

Blue Cross Blue Shield of Texas is following in the footsteps of other insurers by clamping down on emergency room visits it deems non-emergency. In a memo that made the media rounds this week, BCBSTX says HMO members could be on the hook for their entire medical bills if they go to out-of-network emergency rooms “as a convenience for a condition they don’t think is serious or life-threatening.” Members who’ve made such claims to date will get letters laying out their care options on May 1, and the new review process will kick in on June 4, the memo says.… Full Story

When it Comes to Mortality and Health Insurance Rates, A Racial and Ethnic Divide Remains Prominent in Dallas County

In Dallas County, racial and ethnic disparities remain prominent in areas like maternal mortality and the ability to withstand chronic diseases, even as the disparities among those without health insurance have tightened in recent years. Those are a few takeaways from the Dallas Economic Opportunity Assessment, a new report commissioned by the Communities Foundation of Texas (CFT) and conducted by the Austin-based Center for Public Policy Priorities (CPPP). The groups convened Tuesday morning at CFT to go through the findings at an event featuring comments by Dallas Mayor Mike Rawlings and Dallas County Judge Clay Jenkins. The day revolved around… Full Story

New CMS Data Shows Dallas County Has the Seventh-most Enrollees for ACA Insurance

The Centers for Medicare and Medicaid released final 2017 enrollment numbers relating to Affordable Care Act health insurance Tuesday, and the numbers confirm a report issued in February by an outside group. That report showed us that in Texas, Obamacare sign-ups dipped more than the national average last year. What’s interesting about CMS’ data is that you can download a set that splits it up by county. Doing that, we see that Dallas County has the seventh-highest number of consumers—106,923—who’ve selected a plan via the ACA exchange. About 36,000 of those are new consumers from the fall enrollment period, while… Full Story

Texas Health, Blue Cross Blue Shield of Texas Ink Four-Year Contracts in Final Hour

Texas Health Resources and Blue Cross Blue Shied of Texas have come to terms on new four-year contracts to keep the Arlington-based system in-network for BCBSTX plan holders. With the deal set to expire at midnight on Sunday morning, the two sides signed within the final hour, a spokesperson for the insurer says. A short statement from BCBSTX says the agreement came together “through determined efforts from both sides.” “We were diligent in our negotiations, we used all the time we had available to us,” BCBSTX Market President Dr. Paul Hain added over the phone this morning. “We wish were… Full Story