Reimbursement
The Medical Loss Ratio requirements contained in the Patient Protection and Affordable Care Act take effect on January 1, 2011. Even though the Department of Health and Human Services has yet to certify the recommendation concerning how carriers should calculate the percentage of premium they pay toward medical care and health quality measures, the carriers have to be managing their businesses to hit the MLR targets on January 1st.
A South Carolina Medical Association survey indicates insurance company protocols often interfere with physicians' ability to provide optimal care for their patients.
The owner of a Miami-area HIV clinic has been sentenced to almost six years in prison for his part in a Medicare fraud scheme.
The average per capita cost of healthcare services covered by commercial insurance and Medicare rose 7.08 percent over the past 12 months, according to data released this week by Standard & Poor's.
A new and informative resource is available for providers on the web site of the Centers for Medicare & Medicaid Services (CMS).
IBM and Aetna subsidiary ActiveHealth Management, alongside Medens Corp., will deliver cloud services to help physicians in Puerto Rico share and exchange health information and make more accurate decisions about patient care.
A new competitive bidding process implemented by the Centers for Medicare & Medicaid Services will significantly limit growth in the home care products market in the coming years, according to a new analysis.
On November 24, 2010, the Centers for Medicare & Medicaid Services (CMS) is publishing its final rule updating the Medicare hospital outpatient prospective payment system (HOPPS) and the ambulatory surgical center (ASC) payment system rates and policies for calendar year (CY) 2011.
A class action filed against Florida insurer AvMed Health plans seeks redress for a data breach that occurred when two laptops, containing patient information for 1.2 million members, were stolen from the company's headquarters in December 2009.
Pediatrician and Harvard professor Donald Berwick, MD, chief of the Centers for Medicare & Medicaid Services since July 12, went to Capitol Hill Wednesday to outline the agency's plans for making the programs stronger and more modern, in part by employing health information technology.