East Liverpool City Hospital is seeking more than $6 million in damages after claiming an insurance company is failing to pay the bills of patients. In Common Pleas Court, Prime Healthcare Foundation is seeking restitution from Aetna Health Inc. for breach of contract.
Illinois patients who receive surprise medical bills now have somewhere to turn to under a new law that is now on the books.
The measure allows the Illinois Department of Insurance additional authority to assist consumers who were billed at out-of-network rates after receiving care from hospitals.
In a recent joint paper published in The New England Journal of Medicine, the National Quality Forum (NQF) and Humana called for a new risk adjustment model that accounts for both clinical factors and social determinants of health.
A former Kentucky legislator has admitted he knew his pharmacy was submitting improper bills to insurance programs, but didn’t stop the fraud. Former state Rep. Robert Goforth, 46, pleaded guilty Wednesday in connection with $2.7 million in excess billing.
The American Medical Association (AMA) issued two new Current Procedural Terminology (CPT®) codes for the Moderna COVID-19 vaccine booster and its administration. The new codes are effective March 29.
Twenty-five percent of hospitalized Medicare patients experience patient harm, and 43% of those harm events could have been prevented according to a recent report from the Health and Human Services Office of Inspector General.
