Underpayments, unpaid claims, and other billing complications are a chronic problem for independent health care providers using the Anthem insurance network, Maine doctors and professional associations say.
I went to brunch last weekend and, when the server handed us the bill, she said a 20% service fee was added to cover her benefits and health insurance, but that it was not a tip.
A Jackson County jury awarded $25.4 million in a medical malpractice judgment against a Kansas City doctor in a case where a baby suffered permanent brain damage due to a lack of oxygen at birth.
California awarded the Medi-Cal Rx program to a unit of Magellan Health, a company with expertise in pharmacy benefits and mental health. But Magellan was then gobbled up by industry giant Centene, worth roughly $50 billion, which was looking to expand its mental health portfolio.
The Biden administration this week moved to fix the so-called family glitch in the ACA, which has prevented dependents from getting federal subsidies to buy health insurance even if the insurance offered by the employer is unaffordable.
DOJ has filed a complaint against two laboratory CEOs, one hospital CEO and other individuals and entities, alleging False Claims Act violations based on patient referrals in violation of the Anti-Kickback Statute and the Stark Law, as well as claims otherwise improperly billed to federal healthcare programs for laboratory testing.