Reimbursement

Office of the Inspector General report said Medicare could have saved $4.1 billion between 2005 and 2010 if critical access hospitals were being paid for swing-bed skilled nursing services at the same rates as skilled nursing facilities.

Pennsylvania's smaller Blue-licensed insurer is boasting of some notable results in its accountable care arrangements and is looking to bring similar contracts to small primary care practices.

After $300 million, thousands of hours of labor and a few lost government careers, one of the biggest disappointments in progressive health policy has reached the end of the road.

After a fractious price battle with Blue Shield, Sutter Health is offering more patients a direct option through its own health plan.

If consumers can not make more informed healthcare decisions, they may just end up being skinned alive.

The nation's second largest insurer is taking some flak for declining a second opinion on its information technology security.

Starting next year, health insurers have to give Americans in Medicare Advantage plans and federal exchange policies up-to-date details about which doctors are in their plans and taking new patients.

An increasingly popular strategy in drug plan affordability is again coming under scrutiny from Medicare regulators concerned that some urban seniors are being left out.

The Catholic Health Care System, aka ArchCare, allowed Medicare to be billed for patient care at the highest therapy-based levels, even though its subcontractor RehabCare, was often not providing therapy at those levels, according to the U.S. Attorney's Office.

Inaccuracies in the Medicare Advantage directories may trigger penalties of up to $25,000 a day per beneficiary or bans on new enrollment and marketing.