Healthcare Finance Staff
One of California's largest health systems, Sutter Health, is paying $46 million to settle allegations of overcharging payers with obscured anesthesia billing practices.
More Medicare Advantage plans have earned four stars or higher in the CMS Star Ratings program for 2014, increasing to 43 percent from 27 percent of plans in 2013, an Avalere analysis has found.
Medicare has paid millions in claims for deceased beneficiaries and undocumented immigrants, a government investigation has found.
When President Obama addressed massive problems with the federal health-insurance exchange website last week, he couldn't cite any actual enrollments in health plans offered through the site.
The board of WellCare Health Plans is looking for a new CEO, and is hoping to find someone to expand Medicaid and Medicare managed care.
Covered California, the state's public health insurance exchange, has removed one of its 12 health plans from the site, effectively barring consumers from selecting the insurer until further notice.
The Treasury Department is relaxing the Internal Revenue Services' 29-year-old "use-it-or-lose-it" rule for health flexible spending arrangements, a gesture to businesses from the Obama Administration amid health reform's insurance upheaval.
The Aetna Medicare plan serving Maine and Security Health Plan's Medicaid product in Wisconsin, both highly ranked by the National Committee for Quality Assurance, offer examples of using quality measures to improve care coordination, case management, payment for value, and member satisfaction.
The Democratic and Republican leaders of two key congressional committees have agreed on a framework to scrap the problematic Medicare payment formula for physicians and replace it with one that would link physician reimbursement to the quality of care provided, a step that could put an end to the annual "doc fix" debate.
The criticisms of Healthcare.gov and the leaders responsible for the roll out have been coming fast and furious since the beginning of October. This week, two of those leaders were in the hot seat.