Medicare
publication date
CEO
UnitedHealth Group Facing Criminal Probe for Medicare Fraud
It's the latest concerning development in a tumultuous stretch for the healthcare giant.
Innovation
Congress Eyes Reimbursement Boost for Rural RPM Programs
A bill introduced in both the Senate and House would Improve Medicare reimbursement for rural providers using RPM technology.
Revenue Cycle
Infographic: What's Ahead for the 340B Drug Pricing Program?
The heavily scrutinized 340B Drug Pricing Program is back in the spotlight as the Trump administration targets drug costs in...
Revenue Cycle
What Does Slowed MA Growth Mean for Rev Cycle Leaders?
Medicare Advantage enrollment grew at 3.9% last year despite market conditions unfavorable to payers.
Innovation
New Study: RPM Reimbursement Needs a Reset
CMS spent almost $200 million on remote patient monitoring in 2023, and more providers are embracing the technology to track...
Innovation
A Path for AI ROI? Lawmakers Float Bill for Medicare Reimbursement
Two U.S. Senators have co-sponsored a bill that would create a better pathway for Medicare coverage of FDA-approved AI tools...
Revenue Cycle
Infographic: A Quick Guide to the Reducing Medically Unnecessary Delays in Care Act of 2025
The House of Representatives is considering legislation that would reform the way payers use prior authorization. Which payers would the...
Payer
Medicare Advantage: Why Members and Plans Paid More
Cost shares have as much as doubled as plans get a payment rate hike.
Revenue Cycle
Congress Considers Legislation to Restrict Prior Authorizations
A bipartisan group of physician legislators has introduced legislation in the House of Representatives to reform payer use of prior...
Payer
8 Targets of Trump's Second-Term Healthcare Agenda
A 'dizzying array' of actions in the first seven weeks of President Donald Trump's second term.
CFO
Highmark Health Sees Revenue Growth, $200M Operating Loss
Industry-wide medical trend pressures contributed to Highmark?s 2024 losses.
Payer
Does Our Healthcare System Support Healthy Aging?
Aetna?s Medicare CMO outlines the potential of Medicare Advantage ?to keep people happy, healthy and at home.?