Frisbie Memorial Hospital in Rochester, N.H., has taken formal legal action concerning its exclusion from Anthem Blue Cross and Blue Shield of New Hampshire's narrow provider network, according to a Foster's Daily Democrat report.
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The nation's five largest investor-owned health insurers totaled nearly $80 billion of revenue combined in the third quarter of fiscal year 2013, pocketing about $3.7 billion of that amount in profit.
Health insurer Humana's third-quarter net income decreased 13.6 percent, from $426 million in 2012 to $368 million this year.
Mississippi Gov. Phil Bryant has rescinded parts of his executive order meant to force Blue Cross & Blue Shield of Mississippi to reinstate 10 hospitals owned by Naples, Fla.-based Health Management Associates into its network, according to a Mississippi Business…
CMS has issued more guidance related to its new regulation that generally considers inpatient admissions spanning two midnights as qualifying for payment under Medicare Part A.
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Many health insurers are cancelling individual insurance plans because the policies aren't "grandfathered" and don't meet PPACA requirements, according to the trade group America's Health Insurance Plans.
Medicare inappropriately paid $23 million for services recorded as rendered after beneficiaries had died, despite CMS safeguards meant to prevent such payments, according to an HHS Office of Inspector General report.
Pittsburgh-based Highmark claims Bridgeville, Pa.-based Radiance Surgery Center overbilled it by $1.7 million over two years, according to a Pittsburgh Post-Gazette report.
Third-quarter net income at health insurer Cigna increased by nearly 19 percent, from $466 million in 2012 to $553 million this year.
The Senate Finance and House Ways and Means committees have crafted a proposal that would repeal and replace Medicare's sustainable growth rate, the formula the program uses to determine physician reimbursement rates.