Claims Processing
More than 60 percent of self-insured employers in the United States are expected to offer a consumer-driven healthcare plan this year. Many of them – and their employees – will need to know how to “shop” for healthcare services.
The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule that would increase Medicare payment rates under the IRF Prospective Payment System (PPS) by a projected 1.5 percent in fiscal year 2012 - an estimated $120 million nationwide.
Florida Gov. Rick Scott’s controversial plan to privatize Florida’s Medicaid and CHIP programs covering 2.9 million people continued to move through the Florida legislature last month, though a May 6 end to the current session will leave the House and Senate a short window to reconcile the two versions of the bill.
The California Department of Managed Health Care has asked Blue Shield of California to justify a 37.5 percent increase for approximately 70,000 members who are in managed care plans.
Consumer Watchdog, a non-partisan consumer advocacy group, has called on the administration of President Barack Obama to make health reform waivers "the exception, not the rule."
In what Wall Street analysts are calling one of most contentious hostile takeover bids in recent memory, Tenet Healthcare filed a lawsuit in early April against Community Health Systems, charging CHS with admissions procedures that overbill Medicare.
The Centers for Medicare and Medicaid recently awarded 15 states contracts of up to $1 million each to design new ways to improve and coordinate care for the 9 million people in the country who are beneficiaries of both Medicare and Medicaid.
Congress has approved the repeal of a provision in the Affordable Care Act that would have required small businesses, including physicians, to file an IRS 1099 form starting in 2012 for each vendor purchase of $600 or more.
While the Steward Health Care System may have run into a wall in its efforts to acquire a troubled Miami hospital, two more acquisitions closer to home are heading to fruition, extending the for-profit chain’s reach in its home state of Massachusetts.
The Centers for Medicare & Medicaid Services has issued its proposed update for Medicare payment policies and rates for hospitals in fiscal year 2012, and as always, its not great news for providers.