Medicare & Medicaid

Prescription drug spending was fueled largely by new medicines, particularly for specialty drugs such as those used to treat hepatitis C.

CMS said by the end of next year, 85 percent of all traditional Medicare payments to quality or value and 30 percent of traditional Medicare payments should be tied to alternative payment models.

Women in Medicaid expansion states are far more likely to get screened for breast cancer, according to a new study by the Radiological Society of North America, which released the results at its annual meeting on Monday.

The former CFO of a Long Beach hospital in California, two orthopedic surgeons and two others have been charged in relation to a $600 million fraudulent billings scheme involving illegal referrals of thousands of patients for spinal surgeries.

Federal officials this week charged Pamela Gardner, 53, and Torvis Gardner, 44, both of Springfield, Tennessee, and Dr. Donald Boatright, 70, of Nashville with with soliciting and receiving kickbacks in exchange for making referrals for the purchase of medical equipment, according to the FBI.

This year, Healthcare Finance is asking its audience of healthcare finance decision-makers to help us rank the top issues with its inaugural, "Year that was, year that will be" survey.

As beneficiaries explore options during the current Medicare enrollment period, there are only 227 such plans from which they can choose next year, 20 percent fewer than this year, and the lowest number since the drug benefit was added to Medicare in 2006, according to the Centers for Medicare & Medicaid Services.

People with hepatitis C who sought prescriptions for highly effective but pricey new drugs were significantly more likely to get turned down if they had Medicaid coverage than if they were insured by Medicare or private commercial policies, a recent study found.

An estimated 59 percent of Humana's individual Medicare Advantage members have access to primary care physicians in value-based relationships.

The State of Michigan on Tuesday denied a request by Henry Ford Health System's health plan to allow it to keep two regions, including Detroit, to its approved contract for the state's Medicaid program.