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.
Here’s a big thing to watch for in the wake of the President’s flashy Middle East tour: the AI “acceleration partnership” between the U.S. and the United Arab Emirates.
John Simon, MD, is a big advocate for these elective exams, but the American College of Radiology and some members of the specialty oppose this practice.
KFF Health News interviewed multiple independent pharmacies for a new report, detailing their basements full of generic and specialty drugs as a hedge against supply shocks.
Scott Whitaker, the CEO of the industry lobby AdvaMed, told the Senate Finance Committee that he fears tariffs will only raise the cost of care and put patients at risk if companies are unable to overcome supply chain disruptions.
Citing sources familiar with the matter, the Wall Street Journal reports that UnitedHealth Group is being investigated for criminal fraud, likely stemming from its Medicare Advantage billing practices.