Reimbursement

It's turning out to be a problematic year for health insurance IT management. Another Blue Cross insurer company has been hacked, and this time it seems that subscriber medical information was exposed.

Facing scrutiny over executive compensation, reserves and premiums, California's third largest insurer is under pressure to justify its state tax exemption, and state finance authorities wants to start collecting.

In its annual recommendations to Congress on Medicare policies, the Medicare Payment Advisory Commission recommends a 3.25 percent update to inpatient and outpatient hospital payment rates for 2016, as well as repeal of the Sustainable Growth Rate (SGR) methodology for physician services.

In a new customer experience survey, health insurers are just above the bottom, perhaps in part because the nature of the service and the industry's legacy. But some still came ahead with positive reviews.

A total of 16.4 million non-elderly adults have gained health insurance coverage since the Affordable Care Act became law five years ago this month, a "historic" reduction in the number of uninsured.

The nation's largest insurer may be setting a precedent with restrictions on a risky, though recently popular approach to the most common gynecological surgical procedure.

Clinics allegedly sought reimbursement for injection treatments, physical therapy treatments and other medical items and services not ordered by doctors.

Following the nation's changing demographics at the local level in some major markets, Humana is making a small investment in more convenient service for Hispanic and Latino members.

Some state health insurance markets are in for another exodus of pre-health reform plans, as regulators pursue stability on and off the public exchanges.

Unless Congress takes action by the end of this month, doctors who treat Medicare patients will see a 21 percent payment cut.