Reimbursement
2015 is going to be yet another busy year for health plans with the ICD-10 cutover scheduled for October and Operating Rules penalties (still in the rulemaking process) kicking in on Jan. 1, 2016.
The simple assurance that Republicans have a plan to avoid any major disruption to Obamacare from an adverse Supreme Court ruling may not be so simple.
One of the largest Blue Cross insurers in the American South has taken its first loss in 15 years, showing the challenges of the two main growth areas, ACA plans and Medicare Advantage.
Health insurers treading in legacy business processes are turning to contractors for help ply the new waters of reform, fueling an $8 billion market of its own.
In the guessing game and investigations of the attack on Anthem Blue Cross and Blue Shield, one early hypothesis blamed eastern European cyber mafia. Now, new evidence points further east.
Department of Health and Human Services shifted millions of dollars last year from those agencies to help pay the $1.4 billion cost of running the insurance marketplaces in 37 states, according to an HHS spending document.
Denham allegedly solicited and accepted monthly payments from CareFusion Corp., maker of the antiseptic ChloraPrep, while serving as co-chairman of a National Quality Forum committee in 2009 and 2010.
For the state that pioneered the public insurance exchange only to see dysfunction during the first ACA open enrollment, there are still many miles to go.
Trying to recover $120 million, the nation's third largest insurer is fighting back against an alleged scheme of kickbacks, out-of-network billing and the marketing of supposedly luxurious healthcare.
The Internal Revenue has released temporary regulations and proposals for the health "9010" insurance fees required by the Affordable Care Act.