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publication date

Pharma
A Peek at Big Pharma's Playbook that Leaves Many Americans Unable to Afford Their Drugs
KFF Health News | August 18, 2023
America's pharmaceutical giants are suing this summer to block the federal government's first effort at drug price regulation.
Payer
How CMS' Updates to ACO REACH Model Affect Participating Providers
Jay Asser | August 16, 2023
The federal agency has made the changes after receiving feedback from stakeholders and participants.
Telehealth
Audit: Telehealth Bolstered End-Stage Renal Care During PHE
John Commins | August 04, 2023
However, OIG wants more details on what telecommunications platforms are used.
Payer
Medicare Advantage Members More Socioeconomically Disadvantaged Than Traditional Medicare
Jay Asser | July 12, 2023
New study analyzes differences in characteristics between beneficiaries as they're transitioning from commercial to Medicare coverage at 65.
Finance
Hospitals 'Extremely Pleased' to Receive $9B in Proposed 340B Remedy
Jay Asser | July 07, 2023
The proposed rule by CMS is the remedy to payment rates the Supreme Court deemed unlawful.
Revenue Cycle
5 Revenue Cycle Coding Stories You Missed
Amanda Norris | July 06, 2023
There were several coding stories you may have missed in June.
Technology
CMS Eyes Expedited Pathway to Medicare Coverage of Innovative Tech
Eric Wicklund | June 23, 2023
The proposed Transitional Coverage for Emerging Technologies (TCET) pathway is designed to facilitate Medicare coverage for new treatments that usually...
Payer
Medicare Advantage Overpayments Could Eclipse $75B in 2023
Jay Asser | June 16, 2023
New analysis highlights the need for reform in the private program as it continues to grow in enrollment.
Clinical Care
AMA President: 'I Can't Sugarcoat the Very Real Threats'
Christopher Cheney | June 09, 2023
Jack Resneck Jr., MD, spotlights the challenges and victories of his year-long presidency of the American Medical Association.
Pharma
Patient Advocates Mock Merck's 'Bogus' Drug Price Negotiations Suit
John Commins | June 07, 2023
The drugmaker this week filed suit against HHS, complaining that the Medicare price negotiation mandate is 'unconstitutional.'
Payer
Medicare Overpaid $22.5M for Incorrect Place-of-Service Codes
Jay Asser | June 02, 2023
The Office of Inspector General (OIG) uncovered overpayments in 2019 and 2020 for care provided to Medicare beneficiaries.
Strategy
Oak Street Health Plans Expansion to 4 More States
John Commins | June 02, 2023
The Medicare geriatric primary care network says it will have a footprint in Iowa, Arkansas, Kansas and Virginia by year's...
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