Reimbursement

The Centers for Medicare & Medicaid Services intends to ramp up oversight of providers and to save taxpayers money, according to CMS Administrator Marilyn Tavenner, who announced new anti-fraud measures Wednesday.

Competition, innovation and regulation are spontaneously combusting in one unlikely state, as a company trying to upend HR and group insurance sales comes up against the law.

Two health plans are being barred from further enrollment and another is being warned, as state regulators act on promises to ensure access and quality standards for beneficiaries.

The long-standing problem of hospital-acquired infections, adverse events and medication errors is improving, new data suggest, although 1 in 25 hospital stays still comes with an infection.

As some states try to overhaul their programs for Medicare-Medicaid eligible beneficiaries, Indiana is turning to managed care plans to improve services.

After a year's worth of negotiations, a large health system is testing the limits of its clout and leaving a Blue Cross Blue Shield network, amid allegations of unfair reimbursement.

Seniors living in three states will now need prior approval from Medicare before they can get an ambulance to take them to cancer or dialysis treatments. The change is part of a three-year pilot to combat extraordinarily high rates of fraudulent billing by ambulance companies.

A surge in health insurer competition appears to be helping restrain premium increases in hundreds of counties next year, with prices dropping in many places where newcomers are offering the least expensive plans.

The case for collaboration in accountable care networks is getting a boost in the Puget Sound (Wash.) region.

The case for collaboration in accountable care networks is getting a boost in the Puget Sound region, where Humana had found a partner for a new Medicare Advantage network.