Topics
Reimbursement
Home health agencies get half a percent pay increase
Home health agencies get half a percent pay increase
Revenue Cycle Management
Mary Washington Healthcare latest to outsource revenue cycle 
Mary Washington Healthcare latest to outsource revenue cycle 
Strategic Planning
Two CFOs see promise of AI, but have yet to build a dedicated budget
Two CFOs see promise of AI, but have yet to build a dedicated budget
Capital Finance
Cigna nixes speculation of a Humana merger
Cigna nixes speculation of a Humana merger
Supply Chain
Feds shore up healthcare supply chain in wake of hurricanes Helene and Milton
Feds shore up supply chain in wake of hurricanes
Accounting & Financial Management
Labor expenses continue to challenge hospitals
Labor expenses continue to challenge hospitals
Budgeting
Health system operating margins declined in August
Health system operating margins declined in August
Quality and Safety
US healthcare system ranks last in equity, access
US healthcare system ranks last in equity, access
Billing and Collections
CFPB warns of illegal tactics by medical debt collectors
CFPB warns of illegal tactics by medical debt collectors
Claims Processing
Denials top reason for eroding provider-payer relationship
Denials top reason for eroding provider-payer relationship
Workforce
Elevance laying off 123 California employees
Elevance laying off 123 California employees
Operations
UAB, Press Ganey launch certificate program for healthcare leaders
UAB, Press Ganey launch certificate program for healthcare leaders
Medical Devices
Healthcare chatbots may promote racist misinformation
Healthcare chatbots may promote racist misinformation
Hospital/physician relations
Hospitals, physicians submit opposing views to FTC ruling on noncompetes
Hospitals, physicians submit opposing views to FTC ruling
Construction & Facilities Management
University Hospitals expanding with $3.2 million donation
University Hospitals expanding with $3.2M donation
Compliance & Legal
Johnson and Johnson sues HRSA for blocking 340B plan
J&J sues HRSA for blocking 340B plan
Policy and Legislation
Planned Parenthood, other groups decry executive power in House bill
Planned Parenthood, other groups decry House bill
Community Benefit
AMA pushes for stricter standards for hospital charity care policies
AMA pushes for stricter standards for hospital charity care policies
Accountable Care
NAACOS pushes ACO REACH extension after $1.54B in savings
NAACOS pushes ACO REACH extension
Acute Care
SDOH, tech key to advancing value-based care, says UHG
SDOH, tech key to advancing value-based care
Ambulatory Care
Cleveland Clinic and Amazon One Medical collaborate on primary care clinics
Cleveland Clinic and Amazon One Medical collaborate
Analytics
Interoperability in healthcare moving forward despite challenges
Interoperability in healthcare moving forward despite challenges
Business Intelligence
MD Anderson launches new cancer research center
MD Anderson launches new cancer research center
ICD-10 & Coding
Physician practices examine risk adjustment coding in wake of federal lawsuits
Practices keeping close watch on risk adjustment coding
Meaningful Use
Financial disincentives for providers who commit information blocking 
Financial disincentives for providers who commit information blocking 
Medicare & Medicaid
Elevance Health 'considering options' following star ratings hit
Elevance Health 'considering options' following star ratings hit
Patient Engagement
Patients see narrow networks in ACA marketplace plans, KFF finds
KFF: Patients see narrow networks in ACA marketplace plans
Pharmacy
CerpassRx, Waltz team on AI platform to manage specialty drug spend
CerpassRx, Waltz team on AI to manage specialty drug spend
Population Health
Reproductive care, including abortion, facing challenges
Reproductive care, including abortion, facing challenges
Risk Management
UPMC for You partners to offer Medicaid redetermination coverage in laundromats
UPMC for You offers Medicaid redetermination coverage in laundromats
Telehealth
Telehealth prescribing of controlled drugs extended through 2025
Telehealth prescribing of controlled drugs extended
Mergers & Acquisitions
Cardinal Health set to acquire two companies for combined $3.9B
Cardinal Health set to acquire two companies for combined $3.9B
View more

Medicare/Medicaid device fraud

Photo of outside of a hospital
Feb 26 | Susan Morse
CHS under investigation by DOJ
Q4 earnings report shows AI benefits of Google Cloud partnership, CHS says on same day it revealed civil investigation.
Read more >>
READ
Statue of Justice holding scales
Feb 06, 2023 | Jeff Lagasse
Federal charges levied against 25 defendants in alleged nursing diploma scheme
Defendants purportedly engaged in a scheme to sell fraudulent nursing degree diplomas obtained from accredited…
Read more >>
READ
Oct 27, 2022 | Jeff Lagasse
Centene profits hit $738 million in the third quarter
This financial performance is attributable to a couple of factors, including Medicare membership increasing by 22%.
Read more >>
READ
Photo: Jose Luis Pelaez/Getty Images
Sep 22, 2022 | Susan Morse
Centene settles Medicaid fraud claims with Texas for $165 million
Centene made no admission of liability and maintained its business practices are lawful. 
Read more >>
READ
Jul 22, 2021 | Nathan Eddy
Aetna drops lawsuit against Mednax
​​​​​​​The suit alleged that Mednax racked up more than $50 million in improper payments as a result of unnecessary neonatal testing.
Read more >>
READ
The approval has been met with opposition over fears that Medicaid block grants cause vulnerable populations to lose access to healthcare.
Jan 11, 2021 | Mallory Hackett
CMS approves first Medicaid block grant waiver in Tennessee
The approval has been met with opposition over fears that Medicaid block grants cause vulnerable populations to lose access to…
Read more >>
READ
Jul 02, 2020 |
Ten indicted in $1.4B multi-state hospital testing fraud scheme
The defendants allegedly used their management companies to take over rural hospitals in financial trouble and then used them…
Read more >>
READ
DOJ charges providers in $2B fraud take-down
Jul 02, 2018 | Beth Jones Sanborn
Numerous providers among hundreds charged in historic $2 billion healthcare fraud take-down
Authorities are calling the bust the largest in history, with hundreds charged including…
Read more >>
READ
May 18, 2017 | Kaiser Health News
Feds allege UnitedHealth Group doctored patient records, overbilled Medicare by a $1 billion
Lawsuit alleged the insurer made patients appear sicker than they were in order to collect higher…
Read more >>
READ
Feb 28, 2017 | Beth Jones Sanborn
Brooklyn medical supply company Monack charged with $1.5 million Medicaid fraud
Defendants used fake Social Security number to enroll company in Medicaid, filed false claims related to…
Read more >>
READ

Pages