Reimbursement

Providers will now be held to using the correct degree of specificity in their coded claims to Medicare and Medicaid.

A new peer60 study analyzing services offered to hospitals by HCAHPS vendors shows price, reporting functionality and customer service are all important features to their provider customers.

The provider-run Scott & White Health Plan is the latest to leave the exchange market after alerting members on its website that it will no longer offer individual and family plans on the Obamacare markets.

Overall, CMS said the amount it spent on drugs in 2014 grew by 17 percent year over year, driven by rising pharmaceutical costs.

Drug costs increased more than 17 percent from 2013 to 2014, compared to a 3.3 percent increase in the total cost of claims, according to Medicare Part D data released by the Centers for Medicare and Medicaid Services on Thursday.

Some of the Affordable Care Act's insurance marketplaces are in turmoil as the fourth open enrollment season approaches this fall, but what's ahead for consumers very much depends on where they live.

The researchers analyzed data from more than 6.7 million people who filled prescriptions in January 2012 and followed their patterns of medication use and out-of-pocket spending through December 2014.

Experts are clashing over whether accountable care organizations have lived up to expectations, according to commentaries published in the Journal of the American Medical Association.

CEO Mark Bertolini claimed savings tied to the Humana merger would have helped it remain on the exchanges.

Centene's wholly-owned subsidiary Health Net has agreed to pay $340,000 for violating securities laws on whistleblower awards, the Securities and Exchange Commission announced Tuesday.