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Reimbursement

By Kelsey Brimmer | 09:27 am | July 12, 2012
According to a national study released Wednesday by the Center for Studying Health System Change (HSC), contrary to popular belief, the majority of emergency department (ED) visits by nonelderly Medicaid patients are actually for signs and symptoms of urgent or more serious medical conditions or emergencies rather than routine care.
By Healthcare Finance Staff | 12:35 pm | July 10, 2012
In the second half of 2011, the New York eHealth Collaborative (NYeC) shifted its role from a policy convener to a service provider that runs the health information exchange (HIE) infrastructure for the local HIEs and regional health information organizations (RHIOs) like a public utility.
By Diana Manos | 10:21 am | July 10, 2012
The Centers for Medicare & Medicaid Services has added 89 more accountable care organizations (ACOs) to coordinate care and improve quality for Medicare patients in 40 states and Washington, D.C.
By Healthcare Finance Staff | 10:04 am | July 10, 2012
Health Information Partnership for Tennessee (HIP TN), which was convened three years ago to help the Volunteer State develop a statewide health information exchange, has voted to "wind down" operations.
By Kelsey Brimmer | 09:04 am | July 10, 2012
On Friday, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update many payment policies and rates involving services for Medicare beneficiaries in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) beginning on Jan. 1. 2013.
By Chris Anderson | 11:18 am | July 09, 2012
In a bid that will nearly double the number of members it serves in the Medicaid market, WellPoint Inc. today announced it will acquire managed care company Amerigroup for $92 per share or roughly $4.9 billion.
By Chris Anderson | 10:29 am | July 09, 2012
A lawsuit filed July 3 by doctors and medical groups including the Los Angeles County Medical Association and the California Medical Association accuses health insurer Aetna of systematically threatening to deny coverage to members who receive out-of-network referrals for healthcare.
By Healthcare Finance Staff | 12:45 pm | July 06, 2012
An individual who wants to obtain health coverage through Medicaid, health plans on the coming insurance exchanges or help with paying for them will fill out a single online application for any of the programs in 2014.
By Healthcare Finance Staff | 12:33 pm | July 06, 2012
A California lawsuit filed July 3 by a number of medical groups including the Los Angeles County Medical Association and the California Medical Association accuses health insurer Aetna of regularly and systematically threatening to deny coverage to members who receive out-of-network referrals for healthcare.
By Healthcare Finance Staff | 10:02 am | July 06, 2012
The eHealth Initiative (eHI) has concerns that the proposed regulations for health information exchange could unintentionally stifle innovation and hinder the growth of data exchange.