Latest Headlines

Latest Headlines

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.  

If enacted, Clinton's 'Medicare for some' proposal may help hospitals

I'm not sure what to make of 86-year-old William Hager, who almost certainly will spend what remains of his days behind bars for shooting and killing his 78-year-old wife. He claimed the couple...

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.  

Care at critical access hospitals can be better and cost less

It is actually safer and less expensive to undergo some common surgical procedures at critical access hospitals, according to a new study published in the  Journal of the American Medical Association.

Hillary Clinton's 'Medicare-for-more' won't succeed without a focus on improper payments

Last week, Democratic presidential candidate Hillary Clinton made a surprising tweak to her position on healthcare, advocating for a buy-in program that would allow people 50 and older to purchase insurance through Medicare. In order for a "Medicare-for-more" program to succeed, policy makers have to take a proactive approach towards Medicare's inflated improper payment rate, rather than treating it as an afterthought.

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.  

Hospitals want Part B proposals narrowed in scope

The American Hospital Association has praised the proposed Part B drug cost savings demonstration project, but believes a federal agency should narrow its scope.

Raising Medicare eligibility age could increase healthcare spending

Increasing Medicare's eligibility age from 65 to 67 would lead to a 30 percent spike in healthcare spending across the country thanks to wide price discrepancies between Medicare and private insurers, according to a new study published in Health Affairs.  

Partners boo-boo could cost Massachusetts $160M in Medicare payments

Calculation errors regarding the wages paid by a tiny 19-bed hospital in Massachusetts could wind up having an outsized impact on the Medicare payments given to the other acute care providers statewide,  The   Boston Globe  reported.

Health economist: Competitive Medicare Advantage bidding could save gov't billions

Lack of a competitive bidding process in Medicare Advantage costs the government billions in overpayments. But plans to introduce it are probably doomed, according to a New York Times columnist....