Medicare/Medicaid
publication date
Finance
'Burdensome' and 'Difficult': The AHA Takes Aim At New Legislations
Changes under new legislative proposals?from 340B requirements to site-neutral payments?could cost hospitals big if approved.
Revenue Cycle
Whistleblower Gets Large Health System Dinged Half a Million for Overbilling
Yale New Haven Health and Northeast Medical Group have agreed to a hefty settlement for allegedly submitting false claims to...
Revenue Cycle
FAQ: Review Patient-Centered Changes for the End of the PHE
Revenue cycle success is closely tied to the patient experience, so make sure to keep the patient in mind and...
Payer
Covenant Healthcare Paid $69M to Settle FCA Allegations
Two physicians allegedly involved in the scheme to defraud Medicare, Medicare, TRICARE and other government payers will also pay a...
Strategy
The Exec: Trinity Health's CEO on How to Improve Care Delivery, Payer Models
Michael Slubowski talks candidly about the future of healthcare and rising costs for nonprofit health systems.
Post-Acute
Hospice Services Shown to Reduce Medicare Costs, Contributing $3.5B in Savings for 2019
Earlier enrollment in hospice services can increase Medicare savings.
Strategy
AHA, AHIP, AMA, PhRMA Alliance Urges SCOTUS to Uphold False Claims Ruling
Billions of dollars at stake as high court takes up central tenets of the FCA.
Post-Acute
Being 'Socially Frail' Comes With Health Risks for Older Adults
People who are physically frail have less physiological strength and a reduced biological ability to bounce back from illness or...
Payer
OIG: Identifying Denied Claims in Medicare Advantage Needed to Combat Fraud
Medicare Advantage (MA) plans aren't required by CMS to include indicators in their encounter data, unlike Medicare and Medicaid.
Innovation
California's 'Whole Person Care' Program Reduced Medicaid Costs for High-Risk Patients
A five-year pilot project launched by California's Medicaid program that addressed social determinants of health in high-risk, high-utilization patients reduced...
Pharma
Biden's SOTU Bully Pulpit Flays Pharma
President raps 'record profits' from insulin sales; pushes $35 universal cap.
Telehealth
It's 'Telehealth vs. No Care': Doctors Say Congress Risks Leaving Patients Vulnerable
The $1.7 trillion spending package Congress passed in December included a two-year extension for telehealth, but also signaled reluctance to...