Reimbursement
St. Joseph Medical Center in Towson, Md., has agreed to pay $22 million to the federal government to settle allegations of violating the False Claims Act, Anti-Kickback Act and Stark Law, the Office of the Inspector General announced Tuesday. The federal investigation was triggered by physician whistleblowers.
The McKesson Corporation has secured deals with three of the four federally-approved Recovery Audit Contractors and will be providing medical necessity analytics tools for Medicare's auditing efforts in 43 states.
With Medicare and TRICARE physician payment cuts of 25 percent looming, the American Medical Association and the Military Officers Association of America are calling on Congress to protect healthcare for military families and seniors.
The 120 network hospitals and 30-plus physician groups participating in Blue Shield of California's (BSC) claims transparency program continue to reap shorter claims cycle times and fewer denials, resulting in significant savings.
The Institute of Medicine Committee on Geographic Variation in Health Care Spending and Promotion of High-Value Care opened its first meeting Tuesday in Washington, D.C.
The Institute for Clinical Systems Improvement, a nonprofit organization comprised of 60 medical groups and six health plans in Minnesota and surrounding states, will use decision support technology to help ensure patients only receive medically appropriate diagnostic imaging tests.
Nuance Communications announced Wednesday that the Institute for Clinical Systems Improvement (ICSI), a nonprofit organization made up of 60 medical groups and six health plans throughout Minnesota and surrounding states, has licensed its RadPort decision support technology to help ensure patients only receive medically appropriate diagnostic imaging tests.
Variations in insurance markets from state to state mean there is no single formula for how to set up the new health insurance exchanges, as required under healthcare reform.
A new poll conducted by the American Medical Association indicates 94 percent of Americans are concerned about a looming 25 percent cut in Medicare reimbursements to doctors.
Robust healthcare IT systems able to specifically classify treatments based on an individual patient's profile are vital for payers in order to properly manage value-based benefits according to Mark Fendrick, co-director of the Center for Value-Based Insurance Design, and other industry experts - representing health plans, government and service providers - all speaking Monday at the AHIP Fall Forum.