Pharmacy claim reversals can be costly. Not only can they have an immediate impact on pharmacies’ cash flow; but, in many cases, they can lead to additional consequences as well. Pharmacies accused of ...

Federal officials have a plan that could curb billions of dollars in overpayments to Medicare Advantage plans. But will they ...

Established in 1965, Medicare and Medicaid are two separate, government-run health insurance programs that provide essential health care coverage for specific populations. If you've ever wondered ...

On May 12, 2025, President Trump issued an Executive Order entitled “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients” in which he instructed his Administration to create ...

CMS proposes a 0.09% Medicare Advantage payment increase for 2027 and plans to eliminate chart review payments, impacting insurers’ revenue.

Some people may lose Medicaid coverage when they qualify for Medicare at age 65. This situation, known as the Medicare cliff, can lead to altered benefits, coverage, and increased costs. People living ...

Medicaid, in particular, has become increasingly vulnerable to fraud, improper payments, and administrative loopholes. Over the past decade, the program has lost approximately $1.1 trillion to such ...

2025 DEC 09 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News-- Current study results on Managed Care have been published. According to news originating from New York City, New ...

In a startling development, a Minnesota building that was originally a linen factory is allegedly now housing around 400 ...

A health care industry entrepreneur and a registered nurse have accused Palm Beach County, Fla.'s JFK Medical Center of fraudulent Medicare and Medicaid billing practices involving millions of dollars ...