Healthcare Finance Staff

For Medicare contract sponsors to remain viable, it's now necessary to perform a comprehensive Medicare program compliance review. Proposed rule changes may give CMS additional authority next year.

With spending on diagnostics alone for cardiovascular disease likely to be a major challenge for insurers amid the baby boom wave, Aetna is turning to an emerging option as part of a strategy to avoid invasive tests and treatments.

The insurer-owned Allegheny Health Network is partnering with a national cancer center to offer new therapies and trials in western Pennsylvania, a sign of heightening regional competition and the emergence of new models for pursuing innovative treatments.

The growth of total U.S. medical costs is slowing down, but one segment is expanding fast enough to catch insurers by surprise.

The Office for Civil Rights, the HHS division responsible for enforcing HIPAA, is slated to get a new director after the official departure of Leon Rodriguez.

As the final chapter of WellCare's fraud saga closes, the company is lining up new executives and trying to grow.

Two years after upholding most of the Affordable Care Act, the U.S. Supreme Court has carved out a new religious exemption for employers, once again bringing women's health into the political fray and potentially adding new complications to group insurance.

The prospect of a near-duopoly healthcare market is becoming a reality, and only time will tell if two giant closed networks are good for both patients and business.

A regional patient-centered medical home demonstration is appears to be prime for expansion of Medicare members.

The Obama Administration wants to make it as easy as possible for the 8 million Americans who bought insurance via an exchange last year to keep their plans. To that end, the auto-enrollment policy Health and Human Services unwrapped aims to reduce complexity for insurers, but it also brings new issues.