Reimbursement

One impending deadline of the Affordable Care Act that flies under the radar is the one in which payers must comply with the mandate on electronic claims reimbursement.

States could potentially save millions if they adopted the Medicare competitive bidding payment amounts to purchase medical equipment instead of the higher Medicaid fee schedule amounts, according to a recent report from the Department of Health and Human Services Office of Inspector General (OIG).

A recent survey by the health rewards marketing company EveryMove indicates health insurers aren't fully embracing mobile technology -- a critical strategy as the nation moves toward mandatory health information exchanges. Blue Cross Blue Shield of Michigan is making a move to stay ahead of the curve.

California Governor Jerry Brown is deciding whether to sign a bill regulating quasi-generic versions of specialty biologic drugs known as biosimilars -- and some provisions have raised cost and access concerns among health payers like the California Public Employee Retirement System.

Contractors hired by Medicare to audit payment records have a good track record spotting improper billing, the Department of Health and Human Services Inspector General concluded in a report, but some legislators and providers still have concerns.

Last month, the Institute of Medicine published a much-awaited report which recommends that the Centers for Medicare and Medicaid Services should not adjust Medicare payments geographically, but should continue to focus on value-based payment reforms.

Hospitals with a grip on market power in a region can charge prices that are as much as 60 percent higher than the area's lowest-priced hospital for inpatient services, according to a report released Thursday by the Center for Studying Health System Change.

Hospitals with a grip on market power in a region can charge prices that are as much as 60 percent higher than the area's lowest-priced hospital for inpatient services.

In the last of a trio of surveys exploring attitudes toward the bundled care model, payers and employers indicated that they are not sold on it.

In the last of a trio of surveys exploring attitudes toward the bundled care model, payers and employers indicated that they are not sold on it.