Reimbursement

The House Energy and Commerce Health Subcommittee is looking at ways to move beyond the Sustainable Growth Rate formula, the current method of paying Medicare physicians.

Recovery Audit Contractors (RACs) have identified $365.8 million in improper payments made to Medicare providers from October 2009 through March 2011. The payments were issued as long ago as three years prior to the dates on which they were identified by the RACs, marking the limit of the lookback period in which contractors were allowed to search.

EMD Serono, an affiliate of German drug maker Merck, has agreed to pay $44.3 million to settle a lawsuit alleging false claims submissions to Medicare and Medicaid for the multiple sclerosis drug Rebif.

Nine in 10 American workers either have no idea what their healthcare costs are likely to be in retirement or underestimate those costs, says a new consumer survey from Sun Life Financial.

"Historically, telehealth hasn't received the attention that it's deserved from the federal government," says Neal Neuberger, executive director of the Institute for e-Health Policy and president of Health Tech Strategies.

A new study by the National Center for Policy Analysis shows that states and the federal government could save $33 billion in prescription medication costs by switching to models used by Medicare and other private payers.

Aetna has announced a collaboration with Mindbloom, a Seattle-based social media company, that will offer plan members an enhanced version of Life Game, Mindbloom's online social game for personal wellness.

Fifteen percent of U.S. nursing homes receive deficiency citations for infection control each year, according to a new study.

The Thomson Reuters Healthcare Spending Index for Private Insurance showed that costs to people covered under employer-sponsored health insurance rose at a rate of 5.8 percent last year, which was down from 6.6 percent in 2009.

The Centers for Medicare & Medicaid Services told Florida officials it could not extend the state's current managed care waiver for Medicaid to a statewide program. The pilot program, granted a waiver to run in five counties in 2006, has been the model for recent efforts by the state to reform its Medicaid program.