Reimbursement

Bridges Health Partners says Aetna profited from value-based contract manipulation.

Witnesses and members of Congress slam insurers for making money while providers struggle.

The complaint alleges that Regeneron fraudulently inflated Medicare reimbursement rates for a retinal disease drug.

<p>This includes large print, braille, audio recordings and the newest piece, providing documents in the dominant language, says Ernie Crawford, president and CEO of Crawford Technologies.<br />  </p>

The AHA is also concerned about a proposed mandatory model for five clinical episodes.

Eighty percent of practices have lost revenue due to unpaid claims, say respondents to an AMA survey.

<p>1upHealth leverages FHIR for interoperability and improved data flow for clinical claims, says CEO Joe Gagnon.<br />  </p>

<p>Consumers are looking for a more collaborative singular healthcare journey that focuses on preventative care, as well as the social aspect, says Adam Chee, associate professor, National University of Singapore.</p>

The proposed rates for hospices that do not submit required quality data would be -1.4%.

CMS is asking for feedback on having a star ratings system for IRFs.