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.
Some investment analysts are predicting a more permissive M&A market, deregulation as a catalyst for growth and fiscal policies that stimulate economic activity. And they see AI as a catalyst in the shift.
After Luigi Mangione, the man accused of killing UnitedHealthcare CEO Brian Thompson, was extradited to New York, federal prosecutors unsealed a new set of murder charges.
The U.S. Department of Justice said policies at CVS Health forbade pharmacists from discussing patients and providers who may be prescribing opiates in violation of the Controlled Substance Act.
The Center for Vein Restoration has notified patients about a data breach that occurred in October, exposing financial and medical information on patients from across the U.S.
When regulating AI-equipped medical devices, the FDA might take a page from the Department of Transportation’s playbook for overseeing AI-equipped vehicles. These run the gamut from assisting human drivers to fully taking the wheel.