Latest Headlines

Latest Headlines

Arizona Supreme Court: Hospitals don't have to return payments from Medicaid patients

Arizona's Medicaid program has won a narrow legal victory in state court regarding its ability to file liens against patients if they were hospitalized due to a personal injury and received a payment from a third party for damages.

More Americans receiving previously inaccessible care under ACA

More than 60 percent of consumers enrolled in Medicaid or Affordable Care Act (ACA) marketplace plans in 2016 said they had received medical care that was previously inaccessible or unaffordable, according to a Commonwealth Fund survey.  

Incomplete provider screening leaves Medicare, Medicaid open to fraud

Subpar provider enrollment screening processes continue to plague Medicare and Medicaid, leaving both programs vulnerable to fraud and contributing to nearly $90 billion in improper payments in 2015, according to testimony during a House subcommittee hearing.  

How United grew into a healthcare industry behemoth

Several strategic business decisions, including a restructuring that capitalized on a growing healthcare market, transformed UnitedHealth Group from a small healthcare IT company to the largest insurer in the country with nearly $160 billion in revenue, according to the  Minneapolis Star Tribune.  

Inpatient care--not the ER--drives homeless patient costs

Homeless patients' hospital stays for chronic conditions cost organizations more than those patients' emergency room visits, according to the Boston Herald.

HHS misses key opportunities for improper payment recovery

While it generally complied with federal improper payment reporting requirements, the Department of Health and Human Services fell short in several key areas, according to an independent audit conducted by Ernst & Young LLP.  

Slashing funds for HIE access may actually prove more costly

Missouri Gov. Jay Nixon last week vetoed a $500,000-line item from the state budget that would have funded data sharing between the state's department of social services and its health information exchange, Missouri Health Connection. At the same time, new research reports that easy data sharing between New York City's immunization registry and clinicians' EHRs "significantly" improved the vaccination rates of children. At first glance these two news items don't have much in common. But they do; we're talking about Medicaid.

Missouri governor nixes funding to help behavioral health docs connect to HIE

Missouri Gov. Jay Nixon has made a line item veto of $500,000 from the state budget that would have funded connections between the state's Department of Social Services and its health information exchange, Missouri Health Connection.

Report: Fragmented databases hinder Medicaid provider screening

States and insurers that offer Medicaid managed care plans are forced to pull from nearly two dozen different databases spread across 15 federal agencies in an attempt to screen providers, according to a report from the Government Accountability Office.

Teledermatology boosts access to care for Medicaid patients

By offering virtual dermatology and Medicaid coverage, the number of patients who saw a dermatologist nearly doubled, according to a new RAND Corp. study, illustrating how virtual care can increase patient access to specialists.