Reimbursement

Maryland same-sex couples who wanted to take advantage of a state law that requires insurers to cover pricey in vitro fertilization treatments used to face insurmountable obstacles. Not anymore.

A Michigan hematologist will likely spend the rest of his life in prison after defrauding Medicare and private insurers, and violating the first tenet of medicine, "Do no harm."

North Dakota's largest health insurer has made a quick turnaround after a year of underwriting losses and lost technology contracts.

James Colbert, MD, Harvard medical instructor and ACO Learning Network consultant, on the challenges and opportunities of designing high value networks and the data needed to do it.

A former advisor to President Barack Obama is warning healthcare providers to embrace bundled payments as accountable care organizations fall behind in reaping savings from value-based payment models.

It used to require hundreds of thousands of patients taking a drug to make it blockbuster. But over the last decade drug companies have figured out that they can get to $1 billion in product sales with much smaller populations. The key: sky-high prices.

Administrative bloat may not be the main cost-driver, but the chronic disease problem won't be controlled until administrators, insurers, Medicare and Medicaid simply get out of the way of primary care physicians.

The Centers for Medicare and Medicaid Services on Wednesday proposed a new rule that would reimburse doctors for end-of-life counseling, the very kind of practice that led to the heated “death panel” debate before the Affordable Care Act was passed.

Women are saving a lot of money as a result of a health law requirement that insurance cover most forms of prescription contraceptives with no additional out-of-pocket costs. But the amount of those savings and the speed with which those savings occurred surprised researchers.

There is little question that healthcare payers, like all healthcare organizations, have mounting challenges when it comes to meeting regulatory compliance standards developed to improve the security, clarity and transparency of healthcare insurance information.