Revenue CycleHave a 340B Dispute? Prepare For Possible Changes
HHS released a proposed rule outlining changes it wishes to make to the 340B administrative dispute resolution process.
PayerACA Enrollment Up 17% Compared to Last Year
New customers are flocking to Affordable Care Act (ACA) Marketplace health plans in the early stages of the open enrollment...
TelehealthCongress Pressed to Extend Pre-Deductible Telehealth Waiver
The waiver was included in the 2020 CARES Act but will expire on December 31 if lawmakers don't act.
Revenue Cycle5 Ways to Reduce No Surprises Act Burdens
The MGMA recently detailed five ways the government can help alleviate burdens from certain requirements under the No Surprises Act.
Revenue Cycle6 Recommendations for Overcoming No Surprises Act Hurdles
A workforce group penned a letter to HHS that highlights recommendations for meeting the legislation's deadlines.
PayerOIG: Medi-Cal Made $15.7M in Unallowable Capitation Payments
The California Department of Health Care Services agrees with the audit findings.
Revenue CycleOIG Plans to Keep an Eye on CMS' Price Transparency Enforcement
Health systems are not the only entities now being held accountable for upholding price transparency.
Revenue CycleSutter Health agrees to pay $13 million to settle false claims act allegations of improper billing for lab tests
Sutter Health, a Sacramento-based health care services provider, and its affiliate Sutter Bay Hospitals, the successor to Sutter East Bay...
TechnologyCurrent Machine Learning Efforts Fall Short, But Collaboration in Healthcare Could Help
Adaptive techniques could improve diagnostic effectiveness in five key disease areas, a Government Accountability Office report states, but only if...
Revenue CycleThe Useful 5: Regulatory Roundup for Rev Cycle Leaders
HealthLeaders' regulatory round up series highlights five essential governing updates that cover every aspect of the revenue cycle that leaders...
PayerHHS-OIG says Humana's MA Plan Overcharged $34.4M
HumanaChoice says it 'strongly disagreed' with the audit, which found that 76% of claims 'were not supported in the medical...
PayerHHS-OIG Says Highmark Senior Health Upcoded $6.2M
The payer disputes an audit finding that 70% of the diagnosis codes submitted for 'high risk groups' in 2016 and...