AI Use by Medicare Advantage Blamed for Increased Denial of Nursing Home Services

Over-reliance on artificial intelligence is compromising post-acute care for nursing home residents on Medicare Advantage plans. This view of the problematic use of algorithms for prior authorizations – and denial based on incorrect assessment of patient needs – is at the center of reporting and analysis published in the health, medicine and life sciences publication, […]

CVS Health Explores Sale of LTC Pharmacy Omnicare

CVS Health (NYSE: CVS) is eyeing the potential sale of its long-term pharmacy Omnicare, among other strategic alternatives, according to the company’s top executive. The retail and pharmacy giant recorded a pre-tax loss on assets held for sale of $2.5 billion to write down Omnicare. CVS Health President and CEO Karen Lynch said the company […]

Amazon to Acquire Primary Care Group One Medical in $3.9B Deal

Retail giant Amazon (NASDAQ: AMZN) has agreed to buy primary care organization One Medical in a cash deal valued at $3.9 billion. One Medical’s services as a direct-to-consumer membership-based primary care practice involves the use of a mobile app that helps schedule appointments, renew prescriptions and message with a provider. As of March 31, One […]

Omnicare President Love Exits After 2 Busy Years

After playing a leading role in getting Covid-19 vaccines distributed to nursing homes across the country, Jim Love has stepped down as president of Omnicare. Omnicare, a CVS Health company that provides pharmacy services to SNFs, confirmed that he left at the end of April. “We are very grateful to Jim for his dedication and […]

CMS Works to Further Reduce Inappropriate Medication Use in Nursing Homes as Part of Biden Reforms

The Biden administration’s recent efforts to further reduce inappropriate medications in nursing homes has been a multi-year endeavor for industry leaders, but many in the space believe there is still a long way to go. As part of the administration’s nursing home reforms, the Centers for Medicare & Medicaid Services (CMS) will launch a new […]

CVS, Walgreens Claim Victory as First Nursing Home Vaccine Deadline Passes

The two retail pharmacy giants in charge of distributing COVID-19 vaccines to the vast majority of U.S. nursing homes asserted that the massive project remains on schedule as the first major deadline arrived on January 25, despite multiple reports of frustration in the sector. CVS Health (NYSE: CVS) on Monday announced the completion of the […]

Walgreens, CVS Pledge to Finish First Nursing Home Vaccinations by Jan. 25, AHCA ‘Not Aware’ of Major Delays

The two pharmacy giants in charge of the federal government’s COVID-19 vaccination program for long-term care facilities on Wednesday pushed back on reports that the rollout is proceeding slower than anticipated, while a top industry trade group reported only isolated problems thus far. Both Walgreens and CVS indicated that the push to provide the first […]

Promises, Questions Abound as Azar Floats Christmas Vaccination Target for Nursing Home Residents

The emergency use authorization (EUA) granted to Pfizer’s (NYSE: PFE) COVID-19 vaccine late on Friday launched a flurry of promises and commitments to get the vaccine out to vulnerable long-term care residents as quickly as possible. Alex Azar, the secretary of the Department of Health and Human Services (HHS) suggested on Sunday in an interview […]

Feds ‘Strongly Encourage’ Nursing Home Staff to Receive COVID Vaccine Before Walgreens-CVS Rollout

Nursing home staffers shouldn’t necessarily count on receiving COVID-19 vaccines through a federally backed program run by pharmacy giants CVS Health and Walgreens, and should instead seek out local options as soon as immunizations becomes available, the federal government has indicated. The Pharmacy Partnership for Long-Term Care Program can serve as a backup for nursing […]

Cold Storage, Medicaid Coverage: Inside the Walgreens, CVS Vaccination Deal for Nursing Homes

The federal government last week tapped a pair of retail pharmacy giants to distribute an eventual COVID-19 vaccine to nursing home residents across the country, and while there remain significant questions about the logistics of distributing an as-yet-unapproved vaccine, officials have continued to position the plan as the only workable solution to a massive public […]

Despite COVID Revenue Hit, Omnicare’s President Sees Stronger Future for Long-Term Care Pharmacies

James Love took the top post at one of the nation’s leading long-term care pharmacies in perhaps the most crucial and consequential month in the entire history of the sector: April 2020. In the six months since, the Omnicare president has had to navigate a post-acute and long-term care landscape forever changed by COVID-19, while […]

Omnicare Backs 50K COVID-19 Tests for Nursing Home Residents, Staff in Pennsylvania

Long-term care pharmacy giant Omnicare entered into a partnership with the state of Pennsylvania to provide 50,000 COVID-19 tests for employees and workers in nursing homes, Keystone State health officials announced this week. Omnicare, a subsidiary of retail pharmacy and health insurance giant CVS Health (NYSE: CVS), will start performing the tests free of charge […]

Some Managed Care Plans Lift Restrictions on Skilled Nursing Coverage Amid COVID-19 — But Not All

Multiple managed care plans have made changes to their procedures for admissions to the skilled nursing setting amid the ongoing coronavirus pandemic, with several major companies suspending prior authorization requirements for admissions to a skilled nursing facility. The changes, however, are not uniform — and that’s if the managed care organization (MCO) chooses to make […]

CVS Health CEO: Omnicare Long-Term Care Pharmacy Business ‘Disappointing’

CVS Health (NYSE: CVS) CEO Larry Merlo this week described the health care giant’s experience with its Omnicare long-term pharmacy subsidiary, which serves nursing homes nationwide, as “disappointing.” Speaking Tuesday at the J.P. Morgan Healthcare Conference in San Francisco, Merlo made a small reference to frustrations over struggles in the long-term care space since CVS […]

Feds Sue CVS, Omnicare Over Allegations of Fraudulent Long-Term Care Pharmacy Billing

The federal government on Tuesday announced a civil lawsuit against long-term care pharmacy heavyweight Omnicare, Inc. and its parent, CVS Health (NYSE: CVS), over allegations of widespread billing fraud. The Department of Health and Human Services (HHS), through its Office of the Inspector General (OIG) watchdog arm, accused Omnicare and CVS of illegally “rolling over” […]

When Nursing Homes Hit Financial Trouble, Vendors Feel the Pinch — and Fight Back

When a skilled nursing provider enters receivership or bankruptcy, the safety and wellbeing of the residents is the top priority for all parties involved. The financial struggles raise questions about the continued provision of necessary care, and the safe transfer of operations becomes paramount. But in many recent SNF bankruptcies, or cases where a SNF […]

Skilled Nursing Pressures Force CVS to Take $2.2B Hit in Fourth Quarter

Shares of pharmacy and insurance giant CVS Health (NYSE: CVS) slid on Wednesday after executives reported a $2.2 billion impairment charge related to its long-term health care business. The Woonsocket, R.I.-based CVS took the hit in the fourth quarter of 2018 due to troubles at its Omnicare arm, which provides pharmacy services to long-term health […]