Compliance & Legal

While the plan is heralded by many as the flexibility providers and advocates have been pleading for, a lot still remains unknown.

With the reporting and tech burdens high even by large provider standards, solo and small group practices are preparing for a rough entry.

Consumers Union wants to know why the cost projections submitted by Anthem and Blue Shield are so much higher than some of their competitors and other industry-wide figures.

The bill would require insurers to reimburse out-of-network doctors and health providers at the same rate as what they pay in-network providers.

The owner and manager of three former Miami-area home health agencies will spend 20 years in prison after being convicted of conspiring to commit health care, wire fraud, paying illegal kickbacks as part of a $57 million fraud scheme, the Department of Justice announced.

The approach of MACRA promises sweeping change to healthcare providers. Experts in the field weigh in on what the regulatory implications really mean for providers and how to prepare.

The industry association calls on CMS Administrator Andy Slavitt to focus on the key issues of data sharing and interoperability and to reduce the need for multiple reports from IT systems.

Embattled blood testing company Theranos has filed a notice of intent to appeal the sanctions that the Centers for Medicare and Medicaid Services has imposed on their Newark, California lab.

A whistleblower case believed dead involving claims of inflated Medicare Advantage risk scores has been resurrected by a federal court.

Hospitals and former parent company admitted to knowingly and grossly exceeding 60-day repayment rule for Medicaid overpayments.