Policy and Legislation
The Affordable Care Act (aka ObamaCare) requires health plans to spend at least 80 or 85 percent of premiums on medical expenses and quality improvement - 80 percent for small groups and individuals and 85 percent for large groups.
Intermountain Health Care, Utah's largest healthcare system, has agreed to pay $25.5 million to settle claims that it violated the federal Stark law and False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department said Wednesday.
North Carolina Republican Gov. Pat McCrory unveiled what he called a "comprehensive framework for reform" for Medicaid that would offer recipients integrated physical and behavioral healthcare while simplifying billing and administration for providers.
I think everyone believes that Texas Governor Rick Perry is sincere in his opposition to the Affordable Care Act (ACA aka ObamaCare). But this still doesn’t explain why he’s refusing the expansion of Medicaid that the law brings.
Healthcare spending by the Canadian federal government will reach a record high level of $30.3 billion in 2013-14, according to an announcement made this week by the nation's Ministry of Health.
Under a withering barrage of pressure from the insurance industry, seniors groups and congressional members from both sides of the aisle, CMS on Monday did an about-face and significantly raised its 2014 growth percentage estimate for the Medicare Advantage program.
Bruce Greenstein, secretary of the Louisiana Department of Health and Hospitals will step down amid state and federal investigations into a $185 million Medicaid contract awarded to a company where he briefly worked.
Maryland officials have proposed what analysts call the most ambitious initiative in the country to control soaring medical spending, a plan that would bring relief to employers and consumers footing the bill while bluntly challenging the state's powerful hospital industry.
Home care companies have an opportunity to expand their businesses and shape coordinated care efforts by offering their services to hospitals seeking to avoid patient readmissions, say home care experts.
MedPAC has released its annual report to Congress on Medicare Payment Policy, including payment update recommendations for all the major Medicare FFS payment systems and limited Medicare Advantage (MA) recommendations.