Providers utilize business intelligence to monitor referral patterns and collaborate with clinicians who order their services. Such analytics tools have also been deployed in the specialty to improve productivity, track patient satisfaction and bolster quality.
The Medicare Advantage insurer said the payout is equal to what a CMS audit stated was the total amount the company was overpaid for patient care services. Despite receiving the cash, the agency has yet to officially withdraw its enforcement action, as the two parties are still negotiating.
A report from Trilliant Health looking at payer data found that, as prescriptions for the popular weight loss drugs spike, so rises the number of approved benefits.
State Attorney General James Uthmeier is forcing the company to hand over thousands of documents related to its pharmacy contracts and reimbursement policies to see if the retail giant is abusing its position in the market as both a pharmacy benefit manager and a retail chain of drug stores.
Medaxiom CEO Jerry Blackwell, MD, MBA, FACC, discusses investor's interest in buying cardiology practices, noting that PE ownership remains relatively low.
Looking at the three largest Medicaid managed care plans related to maternal health, the Office of Inspector General found instances of ineligible providers being included in directories, as well as other errors such as incorrect contact information.
Shockwave Medical, now a part of Johnson & Johnson MedTech, sits at the top of the IVL market, but things are starting to get more competitive. Boston Scientific gained its own IVL system when it acquired Bolt Medical in 2025.
Can you guess the (lightly disputed) champion of healthcare AI suppliers? Here’s a hint. This company caters to physicians and just this week reached a valuation of $12B.
UnitedHealth Group CEO Stephen Hemsley is expected to make the announcement in front of Congress, where he will also offer other policy solutions. The company said it’s still working out details on how to best distribute its profits to customers.
Extravascular ICDs were developed to avoid complications such as vascular injuries, lead fractures and lead infections. Although rare, these issues can cause serious, life-threatening complications for patients.
The insurer is planning to reduce reimbursement timelines for hospitals in Oklahoma, Idaho, Minnesota and Missouri from 30 days to 15. The details are unclear, but the company said the framework could extend nationwide.
In a lawsuit, the EHR giant accuses Health Gorilla, et al., of posing as patient care entities to gain access to nearly 300,000 medical records, in violation of HIPAA. Health Gorilla vehemently denies the allegations.
The Wall Street Journal obtained a copy of a report from the Senate Judiciary Committee, which reviewed more than 50,000 documents sent by UnitedHealth related to its Medicare Advantage patients. The outlet published the findings of the inquiry.