With a number of healthcare payers including UnitedHealthcare and Aetna dropping out of the Affordable Care Act’s health insurance marketplace, the Centers for Medicare & Medicaid Services...
Audits conducted by the Government Accountability Office (GAO) reveal that up to 35 Medicare Advantage plans fraudulently billed the federal government for medical care provided to many of its elderly...
Healthcare policy of US presidential candidates depends on more than their perspective on the Affordable Care Act. With employer-sponsored health insurance still a major aspect of coverage among...
Recently, criticism popped up against the pharmaceutical company Mylan from the Hillary Clinton presidential campaign for its significant price increase for the life-saving EpiPen product. The EpiPen...
While there have been few major problems within the federal Medicare program that have led to any defamation of the federal agency, Veterans Affairs and, specifically, the Veterans Health...
The Patient Protection and Affordable Care Act isn’t merely responsible for creating health insurance exchanges, eliminating pre-existing conditions or even expanding the Medicaid program. The...
The Centers for Medicare & Medicaid Services (CMS) have recently begun implementing additional alternative payment models centered on episodes of care. CMS has proposed new rules for managing the...
The Office of the Inspector General discovered in an audit that the state of Colorado received millions of dollars in unallowable payments from operating the Medicaid Program and the Children's...
Bundled payment programs have been used in a wide variety of medical treatments and diagnostics such as joint replacement therapy and, more recently, cardiac care. The Centers for Medicare &...
The health insurance market seems to be heading toward more and more consolidation as the major payers Humana and Aetna along with Cigna and Anthem seem to be bent on merging, which would essentially...
On July 25, the Department of Health & Human Services (HHS) announced further investment in bundled payment models within the healthcare industry. According to a news release from the Centers for...
One way that health payers can compete more effectively in the current destabilized environment is by investing resources in reinsurance programs. Reinsurance is a method in which a payer can buy a...
With fairly large sects of the political spectrum opposing various provisions of the Patient Protection and Affordable Care Act as many as six years after its passage, it grows vital to examine whether...
The status of Medicaid expansion has floundered around the nation ever since the Supreme Court ruled that individual states will have the option to choose whether or not to expand their Medicaid...
The Patient Protection and Affordable Care Act has a wide variety of reforms that have been implemented to improve care for American citizens. One of these reforms includes a payment model called the...
Ever since the passage of the Patient Protection and Affordable Care Act (ACA), a number of opponents have found factors to criticize within the landmark healthcare law. But has it truly brought more...
Last year, six states including Texas, Wisconsin, Kansas, Louisiana, Indiana and Nebraska filed a lawsuit arguing that a provision within the Affordable Care Act requiring states to cover a Health...
As previously reported, the insurance companies Aetna and Humana are attempting to preserve their health insurance merger by divesting millions of dollars in assets in order to satisfy the concerns of...
The national health payer Aetna continues to make headlines in the month of August after the public learned last month about the Department of Justice’s move to block Aetna’s major health...
The upcoming US presidential elections may impact the future of the health insurance industry and the way healthcare costs are addressed in this country. Whether the Democrats or the Republicans take...