Payer

CMS is proposing rules to the Office of Information and Regulatory Affairs that would impose fines of $1,000 per day against people and organizations that fail to report settlements with Medicare enrollees who allocate funds to future medical services, according…

In a first-time move, the Illinois Department of Insurance is fining Blue Cross Blue Shield of Illinois for failing to provide information to the state after its contract termination with Springfield Clinic.

It’s no secret that the HR function has become more complex in recent years. Thanks to policy changes in State Paid Sick Leave, the Affordable Care Act, demands brought forth by the #MeToo movement (among other changes), today HR professionals…

HHS says it's examining risk adjustment practices that may have led to billions in Medicare Advantage overpayments.

The American Medical Association is speaking out against a recent report from the Medicare Payment Advisory Commission that recommends a continuation of the freeze on Medicare physician fee payment rates.

A coalition of payers, health systems and public entities are partnering to boost health equity and outcomes in Philadelphia.

The American Medical Association has engaged a law firm to look into insurer and pharmacy benefit managers' prior authorization policies, which providers argue have become more complicated and burdensome in recent years, according to the American Journal of Managed Care. 

The U.S. Census Bureau released American Community Survey health coverage data March 17 that shows which states have the largest uninsured populations as a percentage of their total population. 

Anthem won't have to face a lawsuit for now that alleges the payer under-reimbursed Tampa, Fla.-based air ambulance company Jet ICU for providing out-of-network services to a beneficiary.

A new 50 state survey published March 16 by the Kaiser Family Foundation shows how states are preparing for the end of the Medicaid continuous enrollment requirement.