Reimbursement

The retail health chain that could have helped reprise Humana's historic roots turned out to be a good lesson in the evolving convenient healthcare space, plus it brought a tidy profit.

Amid a ballooning deficit, policymakers in Delaware are scrapping a proposal to introduce more cost sharing for state employees, a decision that may come back to bite when the Cadillac Tax arrives.

The bill proposes to increase payment accuracy, encourage physicians to adopt proven practices, supply doctors with data to improve care, and, for patients, to make Medicare more transparent by them more access to information.

Another cooperative insurer is boasting about low premiums attracting droves of new exchange members, raising questions about long-term viability in the wake of CoOportunity's liquidation.

The new proposal will repeal the current Sustainable Growth Rate and institute a 0.5 percent payment update each year for five years.

Highmark is expanding a low-cost approach to colon cancer screening that could help increase early detection while also avoiding the discomfort of invasive scoping and high treatment costs.

While Congress weighs the sustainable growth rate repeal, insiders have taken to Twitter to voice support for the overdue change.

Insurers in New York are agreeing to reform their policies for behavioral healthcare treatment and rehabilitation coverage, after an "unprecedented enforcement effort of mental health parity laws."

At issue is whether the company is doing anything different from its for-profit competitors to warrant its tax break.

The audit, for years 2011 and 2012, covered $48 million in Medicare payments to the hospital for 7,506 claims potentially at risk for billing errors.