A new report from the RAND Corporation argues that private payers should rework their contracts with hospitals to align their payment rates with those seen in Medicare plans.
The report, which looked...
CMS has issued a letter to state Medicaid directors inviting them to test new, integrated care models for individuals dually eligible for Medicare and Medicaid.
There are 12 million dual eligible...
One of the largest healthcare fraud schemes investigated by the FBI and HHS and prosecuted by the Department of Justice resulted in $1.2 billion in losses and charges against 24 executives of...
As the US population continues to age, older individuals are seeking out comprehensive, affordable care options that meet their specific health needs. Medicare Advantage is one of the most popular ways for consumers to round out their...
Managed care giant Centene Corporation has announced that it will acquire rival payer WellCare Health Plans, Inc. for $17.3 billion in cash and stock.
The latest mega-deal among key players in the...
CMS is seeking to modernize the way Medicare beneficiaries access information about their care and coverage with eMedicare, an initiative that uses online tools and mobile applications to improve...
Medicare and Medicaid contain per enrollee health spending growth better than private insurance which likely indicates that recent policies will be key to sustaining this control, revealed a report...
As the nation starts to turn its politics-weary eyes towards the 2020 election cycle, a new series of healthcare talking points are emerging, particularly from the left-hand side of the ideological...
CMS has launched a new price transparency app that shows users which medical services and tests are covered under Medicare, the agency announced in a recent blog post.
The free...
Walgreens has agreed to pay a total of $296.2 million in settlements for two separate healthcare fraud cases.
The first settlement, approved on January 16, 2019, requires the pharmacy chain to pay...
Most documents intended for Medicare and Medicare Advantage members do not meet accessibility standards for the average reader, according to a new report from VisibleThread, a text analysis...
The partial government shutdown will have no impact on Medicare and Medicaid at the federal level, CMS has stressed to industry observers.
The nation’s public payers will continue to operate as...
Forty-five percent of adults aged 50 to 64 are not confident that they will be able to afford healthcare coverage in retirement, according to a poll conducted by the University of Michigan Institute...
CMS has proposed a new rule that would recalculate Medicare home health payments using a case mix payment model.
In 2020, the agency plans to implement the Patient-Driven Groupings Model (PDGM)...
Several Medicare Advantage (MA) plans entering the market for the 2019 plan year are backed by millions in venture capital funding and are planning to compete with established payers by promoting new...
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...
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...
CMS has announced that Medicare Part A and Part B premiums and deductibles are expected to increase slightly for the 2019 plan year.
Part B members will see small increases in both their premiums and...
Private insurance spending has grown faster than Medicare and Medicaid spending since 2016, even though national enrollment has plateaued, says a new report from Altarum.
The report suggests that...
DaVita Medical Group has agreed to pay $270 million to the Medicare program after identifying suspect billing practices that incorrectly raised its Medicare Advantage payments, says the Department of...
