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Can Anthem, the insurance giant famous for the for-profit Blues, "reconceive Medicaid as a care-delivery model rather than as an insurance program"?

For years, the U.S. Department of Justice has been investigating individual facilities within UHS for alleged fraudulent billing practices to Medicare and Medicaid.

According to the nonprofit healthcare provider, operating revenue was $4.3 billion in the second quarter compared to $3.5 billion in the prior period.

Transparency mandates make it tricky for health systems, as a procedure’s cost and what patients pay is very different.

Many providers are still utilizing technology that goes back decades and doesn’t have the functionality for an increasingly complex billing landscape, which raises the question: Are first-generation RCMs ripe for a "rip and replace" treatment?

While reimbursement is still being determined, it’s estimated that lung cancer scans for eligible individuals could cost Medicare more than $9 billion for the scans, biopsies and treatments through 2020.

Armstrong v. the Exceptional Child Center Inc. ruling is a blow to healthcare providers who say they are losing money in seeing patients covered by Medicaid due to inadequate reimbursement.

Are exchange insurers failing to adequately cover mandated tobacco cessation at no cost-sharing, or just not explicitly highlighting the benefits?

In October 2014 ,the company agreed to pay $350 million and another $39 million in civil forfeiture to resolve claims it violated the False Claims Act by paying kickbacks to induce the referral of patients to its dialysis clinics.

Across the Mississippi River from a bankrupt cousin, a Midwestern cooperative insurer is entering year two with a sizable membership that will test its model of partnering with hospitals.