In November, a public comment sent a Green Mountain Care Board analyst on a curious quest: Why were some Medicare recipients paying more out of pocket for outpatient services at rural, “critical ...

While CMS’ addition of more 573 codes to the ASC Covered Procedures list has been cause for celebration for many leaders, a Medicare policy affecting coinsurance payments for certain procedures may be ...

Every few years, someone announces that a new technology is about to transform insurance. The pattern repeats: a wave of excitement, a few pilots, then, usually, quiet disappointment. But I think ...

NEW YORK, March 11 (Reuters) - Aetna, a unit of CVS Health (CVS.N), opens new tab, agreed to pay $117.7 million to resolve U.S. government charges it defrauded Medicare by knowingly submitting ...

Federal policy changes that decrease risk pooling will lead to higher insurance premiums for less-healthy populations and greater numbers of uninsured Americans.

Medicare allegedly paid 15M for ED services billed at nonemergency sites, prompting OIG findings and CMS response on improper payments.

Aetna Inc., a national insurer incorporated under the laws of Pennsylvania, has agreed to pay $117,700,000 to resolve allegations that it violated the False Claims Act by submitting or failing to ...