The state is paying Optum, a UnitedHealth Group subsidiary, over $2 million this year to review claims for 14 programs that ...
The hospital fees for doctor or clinic care can range from $50 to more than $1,000 and often are assessed without warning patients, according to the Outpatient Outrage 2026 report released Jan. 29 by ...
The proposed Fair Pricing Act would limit what hospitals can charge for about 60 routine outpatient procedures to 150% of the ...
Providence CEO calls Medicare Advantage reset as hospitals exit networks over reimbursement and authorization issues, urging federal intervention.
Strengthening the standards to which Medicaid managed care organizations are held would likely improve access to and delivery ...
GoodRx reports Medicare covers essential healthcare but omits services like long-term care, dental, and vision, necessitating ...
Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...
A persistent decline is observed in the number of primary care physicians available for new Medicare visits, whereas the ...
The U.S. Department of Health and Human Services (HHS) announced Friday that an audit conducted by its Office of Inspector ...
A deep dive into the work of one Medicaid contractor is offering stark new insights into how often Medicare Advantage plans deny nursing home coverage, how they time their decisions and why it matters ...
The Centers for Medicare & Medicaid Services (CMS) will continue to pay more for Medicare Advantage (MA) plans -- $76 billion more in 2026 -- compared with fee-for-service plans. That higher cost ...
The Centers for Medicare and Medicaid Services (CMS) has released the 2026 Medicare Physician Fee Schedule (PFS) final rule, updating the PFS conversion factor from $32.3465 to $33.5675 for qualifying ...
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