Healthcare Finance Staff
The U.S. Supreme Court has solidified the federal government's authority to limit Medicare reimbursement appeals, with a unanimous ruling denying the claims of a group of hospitals seeking compensation for miscalculated payments going back to the late 1980s.
With the insurance and healthcare landscape in this country changing on almost a monthly basis, payer software vendor HealthEdge has begun conducting regular surveys of insurers as a means to take the pulse of a market at any given time. The surveys, conducted currently at six-month intervals provide a snapshot of the industry.
The Illinois exchange wants to offer in-person consumer assistance in addition to federal navigators, as part of the partnership exchange. Covered California is pretty much covered financially until 2015 with federal grants. And as Wal-Mart expands into healthcare, HHS has rebranded exchanges as "marketplaces."
As Aetna finalizes the acquisition of the managed care insurer Coventry, it is selling one of its own Medicaid businesses, Missouri Care, to WellCare Health Plans, for an undisclosed sum.
Eleven states have received $1.5 billion more in grants from the Health and Human Services Department to support their creation of health insurance exchanges, which must be ready in October for enrollment season.
Uwe Reinhardt had a post the other day at The New York Times economics blog comparing Medicare with Medicare Advantage (MA) plans. He basically sifts through the evidence on which is less costly: Medicare (a public plan) or the private MA plans. But while his column is definitely worth reading, it does not go far enough.
The most eagerly awaited -- if not anxiety-laden -- set of regulations in the healthcare spectrum arrived late Thursday: HHS issued modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules.
Ahead of oral arguments over pharmaceutical patent settlements in the Supreme Court, a Federal Trade Commission report has found that 2012 saw a record 40 "reverse payment" settlements between branded and generic pharmaceutical companies, up from 28 the year before.
Universal American Corp. announced Friday that its subsidiary, Collaborative Health Systems (CHS), has partnered with 15 additional groups of physicians to form accountable care organizations (ACOs), approved to participate in the Medicare Shared Savings Program.
UnitedHealth Group's Center for Health Reform and Modernization has released a report outlining policy ideas for improving the nation's financial and physical health, with proposals for nationwide diabetes prevention campaigns, the use of risk coordinated care and alternative Medicare payment systems designed to eliminate the problems associated with fee-for-service payments.