Reimbursement

After the Centers for Medicare & Medicaid Services denied Maine an expedited review for its $20 million Medicaid reduction plans, the state's attorney general is seeking a federal court review to prompt a decision.

With HHS issuing a final rule that establishes Oct. 1, 2014 as the ICD-10 compliance deadline, physicians and medical personnel are girding themselves for what many officials perceive to be a complex labyrinth of documentation.

Nearly every healthcare organization and affiliated clinician group faces challenges when working to meet new models of care and payment delivery. One industry expert offers six pieces of advice to lower costs, improve care and maximize revenue in the ED.

Even as many states gear up for tougher insurance regulations under the federal health law, Maine lawmakers last year bucked the trend, loosening rules they blamed for some of the highest premiums in the nation.

As care models spring up across the country to test whether patient-centered, accountable care can save money and improve health outcomes, a payer-provider collaboration in Portland, Maine is demonstrating that at least theirs holds promise.

According to the latest RACTrac survey by the American Hospital Association (AHA), Medicare recovery auditors (RAC)-related denials in the second quarter of 2012 soared upwards by 24 percent from the first quarter of 2012.

HealthPartners and Park Nicollet Health Care announced that their boards of directors have signed an agreement to combine the two non-profits to create a comprehensive integrated health system and associated health plan to serve the Twin Cities region and parts of western Wisconsin.

The Certification Commission for Health Information Technology (CCHIT) has announced that it has been named an authorized certification body (ONC-ACB) by the Office of the National Coordinator for Health Information Technology (ONC) to certify electronic health records for the federal Permanent Certification Program for Health Information Technology.

SCAN Health Plan recently agreed to pay the largest overpayment fines in California history, a total of $323 million to both the state and federal governments for Medicare and Medicaid over billings stretching as far back as 1985.

The value-based insurance company SeeChange Health Insurance was recently approved to sell plans in Colorado and is aiming to expand in six other states within the next few years.