Claims Processing

Two Pennsylvania Congressmen – from opposite sides of the aisle – have filed a bill seeking to eliminate a competitive bidding program for durable medical equipment that has frustrated providers and consumers.

The number of veterans receiving VA healthcare and benefits now stands at a record 8.4 million and is projected to hit 8.6 million by 2012, according to VA Secretary Eric Shinseki.

Hundreds, if not thousands, of physicians are scammed by their own patients every year.

Facing continued public outcry and pressure from the California Department of Insurance, two of the state's largest health insurers have scaled back or eliminated their plans to raise rates in 2011.

In 2002, New Mexico made it legal to allow certain psychologists who completed specific training to prescribe psychiatric medicines.

Supporters of poison control centers say a proposed $27 million reduction in funding, part of a package of cuts announced in February by House Appropriations Committee Chairman Hal Rogers (R-Ky.), would close some centers and lead to higher healthcare costs.

Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.) recently introduced a bill that they say would curtail fraud, but opponents say its value is dubious.

A series of new reports from the RAND Corporation outlines the impact that national healthcare reform will have on individual states, estimating the increased costs and coverage that are expected in five diverse states once reform is fully implemented in 2016.

A Republican budget proposal for 2012, to be presented to Congress this week, seeks to save more than $4 trillion over the next 10 years and would dramatically alter how the government funds both Medicare and Medicaid.

The HIMSS Medical Banking Project G7 Roundtable, a specialized think-tank of healthcare stakeholders, has released two new reports on accountable care organizations and real time adjudication of claims.