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Insurance

US government taking dialysis company to court over unnecessary procedures, Medicare fraud
Fresenius Medical Care allegedly performed angioplasties, fistulagrams on end-stage renal disease patients
The advantage of a 'pure' RBP over limiting RBP to non-network providers as a strategic response to the No Surprises Act
It is not what plan sponsors get from RBP that counts, it’s the savings participants get to keep
Anthem and Google partner on synthetic data sets for algorithm training
Will train AI to identify fraud, personalize care
Private insurers paying over 200% of what Medicare covers in care costs
Analysis included over 4000 hospitals in 49 states and Washington, D.C.
Jury finds Ohio radiology company head guilty in $2 million fraud scheme
Submitted false statements on behalf of Portable Radiology Services
CMS puts indefinite hold on radiation oncology model start date
Legislation passed in December to delay implementation
Mallinckrodt to pay $260 million to settle False Claims, kickback allegations
Accused of intentionally underpaying Medicaid rebates for drug, Acthar
Only half of US hospitals disclose pricing for lumbar spine MR exams
Required to disclose pricing under CMS mandate
Imaging facility CEO gets five years behind bars for $250 million fraud scheme
Made bribes and paid kickbacks in exchange for patient referrals
Cardinal Health to pay over $13 million to resolve drug kickback allegations
Accused of violating Anti-Kickback Statute and False Claims Act
Court finds Aetna wrong for refusing proton therapy coverage
Aetna argued unsuccessfully that the treatment is experimental, investigational
Why providers should monitor their remote monitoring
Getting compliant with expanding reimbursement opportunities
Indiana asks insurers, hospitals to find ways to reduce healthcare prices
State has highest healthcare prices in the country
Bon Secours Mercy Health to pay more than $1 million to settle false claims allegations
Accused of making fraudulent sleep apnea diagnoses, billing Medicare
Lown Institute ranks 10 most cost-efficient hospitals in US
Price differences costing Medicare $8 billion in potential savings