Reimbursement

Eighty hospitals want a reversal of a final rule that includes Medicare Advantage in payment calculations.

Compensation increased more than 5% for many specialties but only increased 3.6% among primary care specialties.

Cohere's AI platform has a high auto approval rate, but if another type of care is required before surgery, the tech provides that faster, says Dr. Traci Granston at Cohere.

DOJ says St. Peter fraudulently submitted claims for services performed by an oncology doctor.

The action reverses a July 17 decision that Trinity would no longer accept UHC insurance at any of its practices and facilities.

The settlement claims NIRP illegally paid physicians for referrals to clinics established to surgically treat patients with PAD.

J&J alerted 340B hospitals that it will replace upfront discounts with rebates for Stelara and Xarelto.

The growth poses challenges to providers' credit quality, given growing risks to reimbursement from MA plans.

An automated process resulted in Humana instantly approving 70% of prior authorization requests, says Greg LeGrow, executive director of payer product market strategy at athenahealth, and Mark Fleming, senior director of product at Availity.

Higher Medicare and Medicaid reimbursement is one step the federal government can take to preserve rural care access, CEOs say.