The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include CPT codes for the Moderna COVID-19 vaccine for children aged six months through five...
On average, private payers paid hospitals 224 percent of what Medicare would have paid for the same inpatient and outpatient services, according to a report from the RAND Corporation.
Researchers used...
Safety-net hospitals have faced around $2.2 million in annualized losses due to pharmaceutical companies limiting 340B drug discounts at community and specialty pharmacies, a report from 340B Health...
A California doctor has been sentenced to prison for nearly eight years after his involvement in a $12 million Medicare fraud scheme in which he upcoded and billed Medicare for unnecessary...
The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include CPT codes for two COVID-19 booster candidates from Pfizer and Sanofi-GlaxoSmithKline...
Hospital prices paid by commercial health plans varied between 2012 and 2019, as hospitals with both high and low initial commercial to Medicare price ratios saw increases and decreases over the years,...
HHS ended the first quarter of fiscal year 2022 by reducing nearly 88 percent of the Medicare appeals backlog at the Administrative Law Judge level.
According to the Department’s status report...
The median charge index for hospital evaluation and management (E/M) visits increased by 7 percent during the COVID-19 pandemic, according to a white paper from FAIR Health.
The FH Medical Price Index...
Psychiatrists had significantly lower performance scores, received more penalties, and earned fewer bonuses in the 2020 Medicare Merit-Based Incentive Payment System (MIPS) compared to other outpatient...
Global hospital budget models with a volume adjustment system could help limit hospital spending growth for commercial payers and patients, according to an issue brief from the Commonwealth...
The American Hospital Association (AHA) has expressed support for electronic prior authorization processes but urged the Office of the National Coordinator for Health Information Technology (ONC) to...
Following a recent Medicare Payment Advisory Commission (MedPAC) report, the American Medical Association (AMA) has asked Congress to update the Medicare physician payment system to include a stable...
Following the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare claims for telestroke services increased in rural and urban emergency departments. However, there was still substantial...
The American Hospital Association (AHA) has asked CMS to work with Congress and require Medicare Advantage plans to waive prior authorization processes during the current and future public health...
Receiving care from higher-priced hospitals only led to better health outcomes when the facility was in a relatively unconcentrated market. There was no association between high prices and mortality at...
Hospitals and physician offices charged patients significantly higher amounts for drugs than specialty pharmacies did, according to a study from AHIP.
Rising drug prices have contributed to high...
The cost of emergency ground ambulance services increased by 22 percent from 2017 to 2020, giving advanced life support ambulance rides a price tag of more than $1,200, according to a white paper from...
Guidewell, the parent company to health plan Florida Blue, has partnered with an artificial intelligence company to automate the prior authorization process.
Florida Blue will become the first payer...
Safety-net hospitals have faced losses of up to $9 million due to a handful of drug companies limiting 340B discounts on prescription drugs dispensed through community pharmacies, according to a report...
Electronic claims management adoption increased in 2020 as healthcare providers shifted to remote work environments when possible, but they are still leaving billions of dollars on the table in...