Reimbursement

The Senate Finance Committee will hold a hearing Tuesday, beginning at 10 a.m., to consider President Barack Obama's nomination of Marilyn B. Tavenner for administrator of the Centers for Medicare and Medicaid Services.

States should start tracking self-funding and stop-loss trends, as some self-funding employers may be exposing themselves to high financial and legal risk, a new report from the Georgetown University Health Policy Institute and the Urban Institute suggests.

Consumer directed health plans (CDHPs) that offer low premiums and high deductibles have long been touted as a way to encourage consumers to shop for the best healthcare prices since more of their money is at stake. But that assumption may not be true according to new research from the USC Schaeffer Center for Health Policy and Economics and the RAND Corp.

Regulators in some states are trying to prevent insurers from getting around the health law by extending potentially cheaper, but more limited policies for another year, but other states are giving the firms leeway.

Over the next 10 years health reform will impose upon us about $1 trillion in new taxes and it will take another $716 billion out of Medicare, imperiling access to care for the elderly and the disabled according to Medicare's Office of the Actuaries. It will impose a mandate to buy health insurance on most people and fine us if we don't comply. It will compel all but the smallest employers to provide insurance to their employees and fine them if they don't.

Florida and the Centers for Medicare & Medicaid Services (CMS) need to determine whether the state should repay the federal government for $12 million in Medicaid overpayments, the Department of Health and Human Services' Office of the Inspector General (OIG) recommends in a new report.

A new report from the Urban Institute shows that the financial burden of out-of-pocket medical costs vary widely from state to state -- and regionally -- and offers a first-of-its-kind look at which state's residents could most benefit from Medicaid expansion.

In the new world of healthcare -- one that is focused on collaboration, accountability, providing better care and cutting costs -- Aetna executives view the insurer's newly minted Healthagen division, unveiled last month at HIMSS13, as an indispensible piece of getting things right.

A federal appeals court in Boston has upheld a lower court ruling requiring Pfizer to pay Kaiser Foundation Health Plan $142 million for alleged fraudulent marketing of the epilepsy drug Neurontin, and also let related lawsuits filed by Aetna and a self-funded employer go forward.

The Department of Health and Human Services has proposed conflict of interest and certification rules for navigators and other consumer assisters in federal and state partnership insurance exchanges -- and also proposed a rule that would likely prohibit state attempts to restrict navigators to only licensed brokers and agents.