Payer: Page
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Physicians gain 3% reimbursement boost last year thanks to ACA
States that didn't expand Medicaid in 2014 gave doctors a 3.3% reimbursement raise.
By Nina Flanagan • Oct. 6, 2015 -
Out-of-network charges average 300% more than Medicare rates, AHIP finds
Analysis finds some out-of-network treatments 1,400% higher than Medicare reimbursements but certain industry experts aren't buying it.
By Nina Flanagan • Oct. 6, 2015 -
Explore the Trendline➔
Yujin Kim/Healthcare Dive
TrendlinePayer/provider relationships
As M&A intensifies and companies embrace more holistic and value-based care models, partnerships have become more closely intertwined.
By Healthcare Dive staff -
Risk corridors program to pay insurers 13% what they're owed
The shortfall could take a toll on some insurers trying to find their footing in the exchanges.
By Heather Caspi • Oct. 5, 2015 -
Congress sends ACA small business tweak to Obama
Since the ACA was upheld over the summer, legislators are now focused on tweaking it.
By Heather Caspi • Oct. 5, 2015 -
Inadvertent Medicaid, ACA dual enrollments bring headaches
Medicaid consumers are being told they must repay any tax credits they received for ACA plans.
By Heather Caspi • Oct. 2, 2015 -
Grand jury testimony released in massive L.A. insurance scam
The macabre case involves 21 patients who say they have suffered lasting surgical scars and other injuries.
By Heather Caspi • Oct. 2, 2015 -
Anthem CEO not anticipating divestitures with Cigna purchase
CEO Joe Swedish is expressing optimism as he seeks to close the proposed deal.
By Heather Caspi • Oct. 2, 2015 -
Nursing homes billing Medicare for excessive therapy
The OIG says Medicare's payment system for nursing homes needs a face-lift.
By Heather Caspi • Oct. 2, 2015 -
Deep Dive
Disrupt this: ICD-10 one step in healthcare innovation
ICD-10 flipped the script on healthcare billing but it's not the only disruption healthcare will experience in coming years.
By Jeff Byers • Oct. 1, 2015 -
OCR will launch phase 2 of HIPAA audits in 'early 2016'
Responses to an HHS Office of Inspector General report reveal a vague timeline.
By Jeff Byers • Oct. 1, 2015 -
Report finds health prices not tied to use
Health Care Cost Institute analysis finds some markets have both high prices and use, among other findings.
By Jeff Byers • Oct. 1, 2015 -
Deep Dive
Hell freezes over: ICD-10 becomes a reality
As late as last year, the AMA publicly said it wanted ICD-10 buried for good. But a significant CMS concession helped clear the way.
By Randy Lilleston • Oct. 1, 2015 -
Federal employee health program premiums to increase an average 6.4%
Government officials said the increases are in line with certain estimated private-sector plan markups.
By Jeff Byers • Sept. 30, 2015 -
Survey: consumers spend less than 30 minutes researching plans
Many would rather clean their toilets than research benefits, respondents say.
By Heather Caspi • Sept. 30, 2015 -
GAO seeks improved oversight of Medicare Advantage network adequacy
CMS has not verified the accuracy of networks or the availability of those providers listed.
By Heather Caspi • Sept. 30, 2015 -
More nonprofit hospitals expected to enter health insurance business
It's an upward trend despite significant risks, Moody's says.
By Heather Caspi • Sept. 30, 2015 -
Hawaii proposes waiver on some ACA provisions
The proposal, which seeks to waive SHOP participation in 2017, is the first of its kind in the U.S.
By Jeff Byers • Sept. 29, 2015 -
HHS OIG uncovers $30M worth of mysterious Medicare ambulance rides
It’s not a Scooby-Do plot point.
By Jeff Byers • Sept. 29, 2015 -
House agrees to ACA tweak to block 'small employer' definition expansion
Some believe such an expansion could shake up the small-group insurer market.
By Jeff Byers • Sept. 29, 2015 -
California law allows midwives to care for Medi-Cal patients
Licensed midwives provide another choice for low-cost, high-value care, advocates say.
By Heather Caspi • Sept. 29, 2015 -
D.C. insurance marketplace tests shopping tool
Consumers can now compare plans based on out-of-pocket costs and doctor availability.
By Heather Caspi • Sept. 29, 2015 -
New York health Co-op ordered to shut its doors
The mandate affects 108,000 individual plans signed up through the health exchange.
By Jeff Byers • Sept. 29, 2015 -
30% of payers submitted 2014 ACA provider fee forms late
Many of the late filers told the IRS they were unaware of the new Form 8963 filing requirement.
By Heather Caspi • Sept. 28, 2015 -
Psychiatric group argues mega-mergers bad for mental healthcare access
The American Psychiatric Association has joined the AMA, the AHA and the AAFP in warning regulators against the proposed deals.
By Heather Caspi • Sept. 28, 2015 -
FDA
CMS switches up Medicare clinical lab test payments with proposed rule
The initiative would start a data collection process to set new payment rates.
By Jeff Byers • Sept. 27, 2015
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