Reimbursement

According to the latest RACTrac survey by the American Hospital Association (AHA), Medicare recovery auditors (RAC)-related denials in the second quarter of 2012 soared upwards by 24 percent from the first quarter of 2012.

HealthPartners and Park Nicollet Health Care announced that their boards of directors have signed an agreement to combine the two non-profits to create a comprehensive integrated health system and associated health plan to serve the Twin Cities region and parts of western Wisconsin.

The Certification Commission for Health Information Technology (CCHIT) has announced that it has been named an authorized certification body (ONC-ACB) by the Office of the National Coordinator for Health Information Technology (ONC) to certify electronic health records for the federal Permanent Certification Program for Health Information Technology.

SCAN Health Plan recently agreed to pay the largest overpayment fines in California history, a total of $323 million to both the state and federal governments for Medicare and Medicaid over billings stretching as far back as 1985.

The value-based insurance company SeeChange Health Insurance was recently approved to sell plans in Colorado and is aiming to expand in six other states within the next few years.

As states across the country work to expand Medicaid and build health insurance exchanges, one challenge they will surely face is fraud.

Many patients take their first look at a hospital bill, only to go into sticker shock. A single aspirin for $25? Newborn diapers for $100? Why is it that products we purchase for pennies at the local drug store end up costing so much more in the hospital?

As states across the country work to expand Medicaid and build health insurance exchanges, one challenge they will surely face is fraud.

Blue Cross Blue Shield of Arizona and non-profit health system Banner Health have announced an equal partnership designed to provide a coordinated Medicare Advantage offering to be known as Blue Cross Blue Shield of Arizona Advantage.

SCAN Health Plan, a California HMO, is paying the state of California and the federal government $323 million in fines for Medicaid and Medicare overpayments, some going back to 1985.