Center for Medicare and Medicaid Innovation

Gainey McKenna & Egleston Announces A Class Action Lawsuit Has Been Filed Against AdaptHealth Corp. (AHCO)

Retrieved on: 
Thursday, October 26, 2023
SPO, Insurance, Complaint, Medicare, Person, Diabetes, District court, Center for Medicare and Medicaid Innovation, Sleep apnea, Patient, Centers for Medicare & Medicaid Services, CMS, Health insurance

AdaptHealth is a supplier of home medical equipment for chronic health conditions including diabetes, sleep apnea, and wound care.

Key Points: 
  • AdaptHealth is a supplier of home medical equipment for chronic health conditions including diabetes, sleep apnea, and wound care.
  • AdaptHealth sells medical devices directly to patients, and then bills patients’ insurance providers, including the Centers for Medicare and Medicaid Services (“CMS”).
  • As a result of these alleged misrepresentations, AdaptHealth common stock traded at artificially inflated prices during the Class Period.
  • If you wish to discuss your rights or interests regarding this class action, please contact Thomas J. McKenna, Esq.

Ekso Bionics Reports Third Quarter 2023 Revenue Growth of 38%

Retrieved on: 
Thursday, October 26, 2023
Research, HMC, Medicare, Center for Medicare and Medicaid Innovation, Acquisition, Centers for Medicare & Medicaid Services, EVO, Marketing, Webcast, Brace, Patient, CMS, SAN, Clothing, Video game, Pharmaceutical industry, Film industry, Rare-earth element, Cryptocurrency, Reinsurance, Indego

The Company sold a total of 41 EksoHealth units in the third quarter of 2023.

Key Points: 
  • The Company sold a total of 41 EksoHealth units in the third quarter of 2023.
  • Sales and marketing expenses for the quarter ended September 30, 2023 were $2.1 million, compared to $1.7 million for the same period in 2022.
  • Research and development expenses for the quarter ended September 30, 2023 were $1.2 million, compared to $0.9 million for the same period in 2022.
  • General and administrative expenses for the quarter ended September 30, 2023 were $2.2 million, compared to $2.7 million for the same period in 2022.

NeuroMetrix Reports Q3 2023 Business Highlights

Retrieved on: 
Thursday, October 26, 2023
Dentistry, MA, FDA, Growth, Peripheral edema, PIN, Medicare, Financial result, Quell, Telephone, Fibromyalgia, Quality of life, Q3, Disease, Prescription, COVID, Clinical trial, Risk, CIPN, Partnership, National Fibromyalgia Association, Center for Medicare and Medicaid Innovation, DSM-IV codes, University, Patient, Centers for Medicare & Medicaid Services, CMS, Peripheral neuropathy, Pharmaceutical industry, Cryptocurrency

WOBURN, Mass., Oct. 26, 2023 (GLOBE NEWSWIRE) -- NeuroMetrix, Inc. (Nasdaq: NURO) today reported business and financial highlights for the quarter and nine month period ended September 30, 2023.

Key Points: 
  • WOBURN, Mass., Oct. 26, 2023 (GLOBE NEWSWIRE) -- NeuroMetrix, Inc. (Nasdaq: NURO) today reported business and financial highlights for the quarter and nine month period ended September 30, 2023.
  • Financial results in Q3 2023 were consistent with Company expectations and reflect the substantial changes to Medicare Advantage risk-adjustment reimbursement implemented by CMS in Q1 2023.
  • Revenue in Q3 2023 of $1.2 million was lower by $0.8 million or 39% from Q3 2022 primarily due to reduced sales volume for DPNCheck.
  • The Q3 2023 net loss was $1.8 million ($0.21 per share) versus a net loss of $1.6 million ($0.23 per share) in Q3 2022.

Pair Team Raises $9 Million Series A to Expand Access to Health Care Services for Medicaid's Most Vulnerable Patients

Retrieved on: 
Thursday, October 19, 2023
Center for Medicare and Medicaid Innovation, Housing, Health, Medicare, Diabetes, Organization, NEXT, Social support, Centers for Medicare & Medicaid Services, Transport, Y Combinator, Medicaid, Food security, Andrew Kohut, Safety, Depression, A1C, Patient, CMS, SAN, Mental health, Hospital, Nursing

SAN FRANCISCO, Oct. 19, 2023 /PRNewswire/ -- Pair Team, a virtual and community-based primary care solution connecting Medicaid's highest-risk patients to high-quality care, today announced it has raised $9 million in Series A funding. The financing was led by NEXT VENTURES, with participation from PTX Capital, Kapor Capital,  Kleiner Perkins, Y Combinator, and several notable healthcare angel investors including Jay Desai. The funding will be used to help Pair Team accelerate its expansion across California by enabling the company to grow its network of safety net organizations and scale its current team to support additional patients.

Key Points: 
  • "Pair Team's hands-on approach is changing lives for thousands of Californians who are not able to access the care needed to better their health.
  • Pair Team is passionate about building a team of individuals who support its mission of improving the well-being of underserved communities.
  • In addition to care providers and other licensed practitioner positions, Pair Team is hiring for a broad number of roles including executive operations and director roles, as well as local community-based care team members.
  • For more information about Pair Team or if you're interested in joining its team, please visit www.pairteam.com .

Integra Connect Establishes the Largest Oncology Provider Footprint in the U.S. through Strategic Focus on Contracting for Value-based, Precision Oncology

Retrieved on: 
Wednesday, October 18, 2023
APM, Health, Medicare, Organization, CMMI, Center for Medicare and Medicaid Innovation, Cropping system, Estate (law), WEST, VBC, OCM, Medicine, Oncology Care Model, Oncology, Pharmaceutical industry, Nursing

WEST PALM BEACH, Fla., Oct. 18, 2023 /PRNewswire/ -- Integra Connect, LLC., a leader in value-based, precision medicine solutions for specialty care, announced that more than 3,800 oncologists from nearly 100 community practices, cancer institutions, and health systems adopted its value-based care (VBC) contracting solutions, in the last 1.5 years. This includes participation in one of the oncology alternative payment models (APMs) administered by the Company.

Key Points: 
  • This includes participation in one of the oncology alternative payment models (APMs) administered by the Company.
  • More providers are moving towards VBC with the aim to drive improvements in the quality of care, the cost of treatment decisions, and the processes that improve overall patient health.
  • Integra Connect's latest oncology APM is with a leading commercial insurer that covers approximately 50 million patient lives nationwide.
  • "This is an exciting milestone for Integra Connect because it reinforces that we are the partner-of-choice for organizations looking to succeed with oncology value-based care," said Raj Mantena, Chairman and Founder of Integra Connect.

InspireMD Supports CMS’ Final National Coverage Determination (NCD) Expanding Coverage of Carotid Stenting (CAS) to Include Both Asymptomatic and Standard Risk Patients

Retrieved on: 
Thursday, October 12, 2023
Center for Medicare and Medicaid Innovation, CAS, Stroke, TEL, EPS, Risk, Blood vessel, Safety, National coverage determination, NCD, Patient, CMS, FDA, Medicare, IDE, Centers for Medicare & Medicaid Services, Clinical trial, TCAR, NSPR, VIVA, PMA, Physician, Medical device, Pharmaceutical industry

TEL AVIV, Israel and MIAMI, Oct. 12, 2023 (GLOBE NEWSWIRE) -- InspireMD, Inc. (Nasdaq: NSPR), developer of the CGuard™ Embolic Prevention Stent System (EPS) for the prevention of stroke, today announced its support for the Centers for Medicare and Medicaid Services (CMS) final National Coverage Determination (NCD) which expands coverage of carotid artery stenting (CAS) and transcarotid artery revascularization (TCAR) to include both asymptomatic and standard risk patients.

Key Points: 
  • Provides additional treatment options for patients and treating physicians; likely expands CAS addressable market
    InspireMD advancing both CAS and TCAR stent delivery platforms along U.S. and E.U.
  • Marvin Slosman, Chief Executive Officer of InspireMD, stated, “We support CMS’s final decision on the expansion of coverage of CAS to include both symptomatic and asymptomatic carotid artery disease patients considered to be either standard or high risk for surgery.
  • The company anticipates filing for Premarket Approval (PMA) in the second half of 2024 when one-year follow up has been completed.
  • InspireMD will provide further updates on this and other recent developments during its regularly scheduled third quarter 2023 conference call in November.

Main Street Health Announces $315M Financing Round to Expand Into 26 States

Retrieved on: 
Sunday, October 8, 2023
Oak, Main Street, Center for Medicare and Medicaid Innovation, Medicare, Physician, CMMI, Brunswick Maine Street Station, Health Navigator, Patient, Nursing

NASHVILLE, Tenn., Oct. 8, 2023 /PRNewswire/ -- Today, Main Street Health, the nation's largest value-based healthcare organization exclusively serving rural America, announced its expansion into 26 states. In conjunction with this announcement, Main Street announced it has raised over $315M in new capital including investment from strategic health plan and provider partners.

Key Points: 
  • NASHVILLE, Tenn., Oct. 8, 2023 /PRNewswire/ -- Today, Main Street Health, the nation's largest value-based healthcare organization exclusively serving rural America, announced its expansion into 26 states.
  • In conjunction with this announcement, Main Street announced it has raised over $315M in new capital including investment from strategic health plan and provider partners.
  • Main Street partners with primary care clinics in rural America by placing a Health Navigator in each partner clinic.
  • Main Street currently partners with over 900 clinics across 18 states with plans to expand into an additional eight states in 2024.

Equity Quotient Partners with the Healthcare Financial Management Association (HFMA) to Provide Healthcare Finance leaders with AI-powered Health Equity Solution

Retrieved on: 
Wednesday, October 4, 2023
Quotient, American Hospital Association, Workforce, Heart, Medicaid, Partnership, IRS, Public, Health care, Health equity, Strategic planning, Equity, CFOS, Organization, Medicare, Healthcare Financial Management Association, Public health, Hospital, Center for Medicare and Medicaid Innovation, Acquisition, Patient, Investment, Risk, HFMA, Health, Health insurance

NEW YORK, Oct. 4, 2023 /PRNewswire/ -- Equity Quotient, a new, AI-powered stakeholder intelligence platform, today announced the launch of its Public Health solution, providing easy access to rich data and insights required achieve health equity mandates to the more than 103,000 members of the Healthcare Financial Management Association (HFMA) across the country. Equity Quotient's data and analytics will enable HFMA members to benchmark their patients and outcomes to the communities they serve on a variety of socioeconomic statistics, helping them prioritize health equity and population health initiatives.

Key Points: 
  • "Healthcare finance leaders are faced with myriad health equity mandates that require advanced data and analytics to understand the communities they serve," said Todd Nelson, HFMA chief partnership executive.
  • Equity Quotient is the leading AI-powered technology partner that provides organizations with public health data and analytics to support the health equity imperative facing the healthcare ecosystem."
  • Together, Equity Quotient and HFMA will support healthcare finance leaders in exploring the current state of health equity metrics in their communities and how they compare to peer regions.
  • "Our goal is to increase access to data to support the nation's journey to health equity," said Perfecto Sanchez, Equity Quotient Co-Founder and Chief Growth Officer.

Avantect Pancreatic Cancer Test Receives CPT Code and Preliminary Payment Determination from the Centers for Medicare and Medicaid Services

Retrieved on: 
Thursday, September 28, 2023
Technology, Genetics, Health Technology, Health Insurance, Biotechnology, Health, General Health, Artificial Intelligence, Oncology, Pancreatic cancer, CMS, Type 2 diabetes, CPT, Centers for Medicare & Medicaid Services, Center for Medicare and Medicaid Innovation, Bangladesh Technical Education Board, American Medical Association, Medicare, Type 2, Patient, Risk, Current Procedural Terminology, AMA, PLA, Research, NIH, Disease, Pharmaceutical industry

Effective October 1, 2023, the new CPT code, 0410U, establishes a reimbursement pathway for increased patient access and broader test adoption.

Key Points: 
  • Effective October 1, 2023, the new CPT code, 0410U, establishes a reimbursement pathway for increased patient access and broader test adoption.
  • The Avantect test is intended for patients at high risk for pancreatic cancer, such as those recently diagnosed with Type 2 diabetes or with a family history of pancreatic cancer.
  • In addition, the Centers for Medicare and Medicaid Services (CMS) announced that it has proposed preliminary reimbursement rate determinations for new and revised CPT codes issued by the AMA, including 0410U for the Avantect Pancreatic Cancer Detection Test.
  • Its proprietary epigenomic methods use a standard blood draw to identify pancreatic cancer signals at its earliest stages by measuring levels of the 5-hydroxymethylcytosine (5hmC) in cell-free DNA.

CORRECTION: Aledade Saved Medicare More Than $572 Million In 2022

Retrieved on: 
Wednesday, September 20, 2023
ACO, Medicare Advantage, Medicaid, CMS, Depression, Centers for Medicare & Medicaid Services, Accountable care organization, Acos, Cigna, CareFirst BlueCross BlueShield, Medicare, Community, Center for Medicare and Medicaid Innovation, Patient, Colorectal cancer, GuideWell, Commercial, Royal Voluntary Service, Health insurance, MSSP, Humana, MD

In addition to being the largest network of independent primary care in the country, Aledade also had the most successful accountable care organizations (ACO) in the country.

Key Points: 
  • In addition to being the largest network of independent primary care in the country, Aledade also had the most successful accountable care organizations (ACO) in the country.
  • Practices in Aledade ACOs earned $294 per Medicare beneficiary - roughly double the average hospital-led ACO savings of $140 per Medicare beneficiary across the MSSP program.
  • That means the average-sized primary care practice working with Aledade earned $218,219 in shared savings payments for providing more proactive, preventive primary care in 2022.
  • Mississippi practices working with Aledade led the nation in providing Annual Wellness Visits to their patients and earned shared savings payments of more than $13 million.