Reimbursement

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.

The former chief financial officer of a now-closed Texas hospital is one step closer to a potential five years in federal prison after pleading guilty to wrongly claiming EHR incentive money.

The Sunshine State's largest health insurer is betting on a well-branded telehealth service with a retail experience.

A tension between transparency and trade secrets has surfaced in North Carolina, where the state's largest insurer believes a new disclosure law will have unintended consequences.

The Obama administration took another step to close what many see as a health-law loophole that allows large employers to offer medical plans without hospital coverage and bars their workers from subsidies to buy their own insurance.