Healthcare Finance Staff
The California Department of Managed Health Care is trying to end the practice of emergency care "balance billing," just as thousands of new HMO members are being created.
After the disastrous launch of Obamacare the enrollment of 1.1 million people in the 36 state exchanges run by the feds is a major accomplishment. It is likely that the enrollment in the 14 state-run exchanges will take total Obamacare's private insurance enrollment to near 2 million for the year.
After several years on the decline, improper payment rates for Medicare and Medicaid increased in 2013, according to the government's estimates. How much of that represents fraud, though, still remains a mystery.
As many as 1.5 million more Medicare beneficiaries now have access to coordinated care with the formation of 123 new accountable care organizations as of Jan. 1, the Health and Human Services Department has announced.
Physicians are getting a three-month reprieve from Congress. Included in the bipartisan two-year budget deal to fund the government is a delay until March of a scheduled 24 percent Medicare payment cut combined with a 0.5 percent pay increase. The president is expected to sign the legislation.
A Medicaid eligibility verification project has come to a partial stop in Illinois, amid one of the largest expansions in the program's history.
Bill Marshall, of Pega Healthcare Solutions, sees similarities between the problems faced by health insurance exchanges and tthe lessons learned by successful mHealth companies.
Many of the accountable care organizations in the U.S. are hospital or primary care provider networks banning together to provide care. A group of federally-qualified health centers in the Minneapolis area has broken the mold by creating the first safety-net ACO.
The Obama Administration tacked a 13th hardship exemption onto the Affordable Care Act before the end of year, offering people with cancelled plans relief from the individual mandate and expanding eligibility for catastrophic plans.
About a year after pitching the option of serving as "web-based" broker for insurance exchanges, eHealth Insurance is getting closer to helping sell Americans subsidized health plans.