Reimbursement
Florida and the Centers for Medicare & Medicaid Services (CMS) need to determine whether the state should repay the federal government for $12 million in Medicaid overpayments, the Department of Health and Human Services' Office of the Inspector General (OIG) recommends in a new report.
A new report from the Urban Institute shows that the financial burden of out-of-pocket medical costs vary widely from state to state -- and regionally -- and offers a first-of-its-kind look at which state's residents could most benefit from Medicaid expansion.
In the new world of healthcare -- one that is focused on collaboration, accountability, providing better care and cutting costs -- Aetna executives view the insurer's newly minted Healthagen division, unveiled last month at HIMSS13, as an indispensible piece of getting things right.
A federal appeals court in Boston has upheld a lower court ruling requiring Pfizer to pay Kaiser Foundation Health Plan $142 million for alleged fraudulent marketing of the epilepsy drug Neurontin, and also let related lawsuits filed by Aetna and a self-funded employer go forward.
The Department of Health and Human Services has proposed conflict of interest and certification rules for navigators and other consumer assisters in federal and state partnership insurance exchanges -- and also proposed a rule that would likely prohibit state attempts to restrict navigators to only licensed brokers and agents.
North Carolina Republican Gov. Pat McCrory unveiled what he called a "comprehensive framework for reform" for Medicaid that would offer recipients integrated physical and behavioral healthcare while simplifying billing and administration for providers.
At a meeting of the Health IT Policy Committee on April 3, National Coordinator for Health Information Technology Farzad Mostashari, MD, and other committee members took a hard look at the CommonWell Health Alliance, a new vendor-led coalition to promote interoperability.
After declining to expand Medicaid earlier this year, North Carolina Republican Governor Pat McCrory unveiled what he called a "comprehensive framework for reform" that would offer recipients integrated physical and behavioral healthcare while simplifying billing and administration for providers.
TriZetto Corporation expects to create as many as 750 new jobs over five years, the healthcare technology company announced April 2 during the opening ceremony for its new worldwide company headquarters in Colorado.
In the first (and perhaps only) delay of health insurance exchange implementation, the Centers for Medicare & Medicaid Services is pushing back by one year the creation of the small business employee choice program in the federal HIX.