Medicare
publication date
Payer
Medicare Overpaid $22.5M for Incorrect Place-of-Service Codes
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
The Medicare geriatric primary care network says it will have a footprint in Iowa, Arkansas, Kansas and Virginia by year's...
Clinical Care
MD and DO Physicians Provide Similar Quality and Cost of Care, Study Finds
Researchers compared the performance of doctor of medicine (MD) and doctor of osteopathic medicine (DO) hospitalists in the care of...
Telehealth
Bipartisan U.S. House Bill Aims to Protect Rural Telehealth
The bill would permanently expand telehealth services that were adopted during the coronavirus pandemic.
Revenue Cycle
GI Docs Rail Against UHC's Looming Prior Authorization Mandate
GI docs say the payer is using AI to move large volumes of services through prior authorization.
Revenue Cycle
Are Commercial Payers to Blame for Majority of Rev Cycle Claim Denials, Payment Delays?
One study says yes.
Payer
Financial Burden of Dual-Eligible Beneficiaries Split Evenly on Medicare, Medicaid
Research into utilization and spending for need-based subgroups suggests integration of the two programs could better serve enrollees.
Revenue Cycle
Medicare Paid Providers $128M in Duplicate Payments for VA Care
Auditors blame CMS for failing to establish a data-sharing agreement with the VA.
Finance
Sibley Hospital, Johns Hopkins To Pay $5M In Stark Law Settlement
The Stark Law violations allegedly took place between 2008 and 2011.
Payer
Medicare Advantage has Lower Utilization, Higher Clinical Care Quality
Performance was higher in Medicare Advantage (MA) health maintenance organizations (HMOs) and preferred provider organizations (PPOs).
Payer
Medicare Advantage Added Record 2.7M Members This Year
Medicare Advantage (MA) growth was led by United and Humana, while nonprofit insurers lagged behind.
Finance
Kentucky Governor Signs Law Increasing Healthcare Access
The measure also ups Medicaid payment rates for outpatient procedures performed at hospitals.