This site uses cookies to improve your experience. To help us insure we adhere to various privacy regulations, please select your country/region of residence. If you do not select a country, we will assume you are from the United States. Select your Cookie Settings or view our Privacy Policy and Terms of Use.
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Used for the proper function of the website
Used for monitoring website traffic and interactions
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Strictly Necessary: Used for the proper function of the website
Performance/Analytics: Used for monitoring website traffic and interactions
Challenges of Investigating Overpayments Undeserved payments are needles lurking in the haystack of 135 million Americans enrolled in Medicare, Medicaid, and the Children’s HealthInsurance Program (CHIP). How can such overpayments be uncovered? public in overpayments. But the needles pile up fast.
Consumers Overpay for Generic Drugs , a new paper from the Leonard Schaeffer Center for Health Policy & Economics asserts, with recommendations to address the intermediaries who benefit from the way Americans currently pay for medicines. The good news about prescription drugs, in the context of medical spending in the U.S.,
Overpayments, billing errors, and the resulting administrative rework creates completely unnecessary conflict and adds costs to the healthcare system that ultimately the consumer is responsible for paying.
Balancing AI-Driven Payment Integrity with Provider Relations A large healthinsurance company implemented an AI-powered payment integrity system to identify and prevent potential fraud, waste, and abuse in healthcare claims. They also streamlined their dispute resolution process to ensure quick and fair resolutions.
Balancing AI-Driven Payment Integrity with Provider Relations A large healthinsurance company implemented an AI-powered payment integrity system to identify and prevent potential fraud, waste, and abuse in healthcare claims. They also streamlined their dispute resolution process to ensure quick and fair resolutions.
Board Certified by The Florida Bar in Health Law On October 7, 2021, 18 former NBA players were charged in New York federal court for an alleged healthinsurance fraud scheme to rip off the league's benefit plan, according to an indictment filed in the Southern District [.] Indest III, J.D.,
Board Certified by The Florida Bar in Health Law On October 7, 2021, 18 former NBA players were charged in New York federal court for an alleged healthinsurance fraud scheme to rip off the league's benefit plan, according to an indictment filed in the Southern District [.] Indest III, J.D.,
– Overpayments in claims processing: This can ensure both providers and payers are fairly compensated. Fostering Healthcare Innovation in Wearable Devices: From fitness bands to smart watches, consumers are increasingly turning to wearable devices to track key health measures.
Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations. Not all forms of technology are recognized as services which can be reimbursed by healthinsurance.
The healthinsurance marketplace was one of the first times insurers had to provide more affordable options based on what an individual may want, not just what was provided by an employer. One great hope of digital health technology is that it will empower the patient and finally make this possible.
Board Certified by The Florida Bar in Health Law On February 16, 2024, a Parkland, Florida, man agreed to plead guilty to organizing a Medicare fraud scheme worth $110 million. By: George F. Indest III, J.D., The federal prosecution is taking place in the U.S. District Court for the District of Massachusetts.
Board Certified by The Florida Bar in Health Law On February 16, 2024, a Parkland, Florida, man agreed to plead guilty to organizing a Medicare fraud scheme worth $110 million. By: George F. Indest III, J.D., The federal prosecution is taking place in the U.S. District Court for the District of Massachusetts.
Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. By George F. Indest III, J.D.,
Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. By George F. Indest III, J.D.,
Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. By George F. Indest III, J.D.,
Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. By George F. Indest III, J.D.,
Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. By George F. Indest III, J.D.,
Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. By George F. Indest III, J.D.,
Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. By George F. Indest III, J.D.,
Even more significant for CMS, is that for the first time in improper payment reporting history, we have achieved improper payment rate reductions across the board in Medicare, Medicaid, and the Children’s HealthInsurance Program (CHIP).
Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. By George F. Indest III, J.D., Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. This came in a ruling that limits regulators’ power to control what the program pays for certain [.].
Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. By George F. Indest III, J.D.,
Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. By George F. Indest III, J.D., Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. This came in a ruling that limits regulators’ power to control what the program pays for certain [.]
NATIONAL 382 rural hospitals cut chemotherapy, breakdown by state 1 year after Amazon-One Medical deal finalized: What’s happened since ACOs want increased participation of long-term and post-acute care providers ‘Behind the times’: DC tries to catch up with AI’s use in health care CMS finalizes DSH payment cuts for some safety-net hospitals: (..)
For example: Had the healthinsurance industry been allowed to continue operating as it did prior to HIPAA, tens of millions of Americans would be excluded from health plan benefits. Had the momentum to improve health care not been given a kickstart by HIPAA, subsequent health care initiatives may never have happened.
New California rule aims to limit health care cost increases to 3% annually UC San Diego Health operations deal with California hospital slows to crawl Kaiser reports data breach affecting 13.4M
spoiler bid for home health care company Thousands of Minnesotans at risk of losing healthinsurance get a one-month reprieve MISSISSIPPI $5.3M for stroke and kidney treatment Optum wins $3.2B
Cedars Leads Latest Round Of Funding In Yolo County, 16,000 Medi-Cal patients lose doctors in Dignity Health dispute with Partnership HealthPlan Kaiser med school names CEO Kaiser Permanente launches food-is-medicine hub Kaiser, Vizient target healthcare greenhouse gas emissions L.A. Can lawmakers do anything about it?
1 in the nation for hospital maternity practices Noramco acquires former Halo Pharmaceuticals FLORIDA 5 AMA members who see advancing health equity as their mission AdventHealth ER rises on Holy Land Experience site Florida Laboratory Agrees to Pay Over $1.1
The New 988 Mental Health Hotline Is Off To A Busy Start In Hawaii. Luke’s is joining the healthinsurance business. Judge Halts Part of Idaho’s Abortion Ban, Saying It Violates Health Law. Idaho Business for Education releases report on health care worker shortage in Idaho. Could it become monopolistic?
Lauren Matteini empowers women in spine, orthopedics and beyond Illinois hospital regains trauma center designation New real estate entity to focus on Midwestern medical office building acquisition OSF plans new Ottawa inpatient hospital across the street from current one OSF to file CON for new hospital SSM Health taps regional chief nursing officer (..)
They also called for the Centers for Medicare & Medicaid Services, or CMS, to revive a foundering audit program that is more than a decade behind in recouping billions in suspected overpayments to the health plans, which are run mostly by private insurance companies. Cathy Rodgers (R-Wash.)
Rhode Island Ranked as the Second-Worst State for Doctors The Centurion Foundation’s purchase of Roger Williams and Fatima hospitals would rely on bond funding In Bethpage, The Safe Center creates mental health clinic School district, pediatric urgent care partner to provide mental health services King nominated as permanent R.I.
in 2024 Lilly cuts undisclosed number of jobs, nothing large scale Several Indiana health care measures focus on the 340B Drug Pricing Program. ’ Now, it’s struggling to recover UnityPoint leans into specialty virtual care KANSAS Kansas mental health center acquires dental practice Walgreens settles for $97.8M What is it?
billion in 2024 Cone Health opens virtual care at housing complex: 5 notes Cone Health board chair and community leader will represent system on Risant Health board NC DHHS denies Novant Healths request for $287M Triangle hospital North Carolina needs more doctors. DeWine’s plans for mental health?
We organize all of the trending information in your field so you don't have to. Join 26,000+ users and stay up to date on the latest articles your peers are reading.
You know about us, now we want to get to know you!
Let's personalize your content
Let's get even more personalized
We recognize your account from another site in our network, please click 'Send Email' below to continue with verifying your account and setting a password.
Let's personalize your content