Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability
  • Insured Critical Illness Beneficiaries Face High Treatment Costs

    October 22, 2018 - Health plan members with critical illnesses face high treatment costs and other financial issues even with comprehensive health insurance, said a new survey conducted by the Harvard T. Chan School of Public Health, New York Times, and Commonwealth Fund. Nine out of ten commercially insured beneficiaries with illnesses like cancer or immune deficiency diseases have health insurance, the...

  • CMS Proposes Drug Price Transparency in Television Ads

    October 16, 2018 - CMS has proposed a new rule that would enhance drug price transparency by requiring drug manufacturers to publish wholesale prices of Medicaid and Medicare prescription drugs during television ads. The proposed rule would require pharmaceutical companies to display the price of a short-term or thirty-day supply prescription before accounting for possible insurer or pharmacy benefit...

  • Medicaid Beneficiaries Face Significant Food Insecurity Challenges

    October 15, 2018 - Medicaid beneficiaries face significant food insecurity challenges and may require additional healthcare programs to reduce food insecurity risks, according to new research from the Root Cause Coalition. Many Medicaid beneficiaries struggle to afford and purchase healthy food options. The survey found that one-third of Medicaid beneficiaries purchase less healthy food because of...

  • AMA, Industry Orgs Object to Short-Term Health Plan Expansion

    October 11, 2018 - The American Medical Association and other industry trade groups have filed amici curiae in support of a lawsuit contesting the legality of short-term health plans. The Association for Community Affiliated Plans (ACAP) contends that the recent federal expansion of short-term health plan enrollment, or the Short-Term Limited Duration Insurance (STLDI) rule, violates several provisions...


Today's Top Stories

Medicare Advantage Plans Proliferate in 2019, Raising Competition

Medicare Advantage (MA) payer competition is increasing significantly for plan year 2019 as more than 400 new options hit an already-crowded market, says a new report from the Kaiser Family Foundation (KFF).   More than 2700...

Insured Critical Illness Beneficiaries Face High Treatment Costs

Health plan members with critical illnesses face high treatment costs and other financial issues even with comprehensive health insurance, said a new survey conducted by the Harvard T. Chan School of Public Health, New York Times, and...

Administrative Plan Costs for Managed Care Payers Jumped 5.7% in 2017

Managed care payers experienced a 5.7 percent increase in administrative plan costs in 2017, for items such as staffing and customer service support, according to an analysis from the Sherlock Company. Spikes in Medicaid enrollment...

BCBS of TN Defrauded $174M in $2B Telemedicine Insurance Scheme

BlueCross BlueShield (BCBS) of Tennessee has been named a damaged party after it was defrauded $174 million as part of a larger $2 billion telemedicine insurance scheme, according to the Department of Justice (DOJ). The District Court for...

Medicare Diabetes Prevention Program May Have Cost Concerns

The Medicare Diabetes Prevention Program (MDPP) may not fully cover provider costs needed to administer classes and other programs to prevent diabetes among Medicare members, says a new report from the University of Colorado (UC) School of...

IL Payers File Pharma Lawsuit Over Opioid Prescription Costs, Safety

A coalition of Illinois payers has sued prominent pharmaceutical companies in a lawsuit that argues the companies are responsible for a spike in opioid prescription costs and patient safety risks. The Intergovernmental Risk Management...

$36.9M in Medicare Fraud Leads to Federal Convictions, Sentencing

New high-profile Medicare fraud cases have led to convictions and lengthy prison sentences for providers that attempted to defraud Medicare of $36.9 million. Federal agencies including HHS, the FBI, the Department of Justice (DoJ), and...

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