Plans for the academic medical center and hospital include 70 ER bays and advanced operating suites and an extensive ...

Under a Medicare GLP-1 Bridge demonstration that runs for a limited time, starting July 1 individuals enrolled in Medicare ...

Payers are addressing over-payments from every computer click and providers are offsetting denials by deploying AI for the ...

The not-for-profit insurer said it is exiting the individual market across all states and the state of Montana across all ...

The Centers for Medicare & Medicaid Services has released an Interim Final Rule with Comment that gives work requirements for adults to obtain Medicaid coverage. Unless an applicant fits the criteria ...

Massachusetts has sued UnitedHealthcare Insurance Company, alleging the insurer defrauded the state's Medicaid program of at least $100 million by making older members appear sicker or more impaired ...

Patrick Lane, Health Gorilla president and COO, says that, without a national patient identifier, healthcare providers struggle with verifying patients' identities and matching them to the correct ...

Insurer is eliminating prior auth for many diagnostic procedures, routine surgeries, and cardiology, neurology, pulmonology and orthopedic specialty care.

The independent dispute resolution process is adding billions of dollars in wasteful spending, according to AHIP and the Blue Cross Blue Shield Association, reacting to a final rule on the independent ...

Special needs plans (SNPs) enrollment is rising and now accounts for 21% of all MA enrollees. According to a new KFF report, that's up from 13% in 2018, when SNPs became a permanent fixture in the ...

Retailers are well-positioned to disrupt healthcare, with a new Definitive Healthcare report showing that retail clinics have seen a 200% increase in utilization over the past five years – higher than ...

The projected average total Part D beneficiary premium is projected to decrease by 1.8% in 2024, from $56.49 in 2023 to $55.50 in 2024, according to an announcement Monday from the Centers for ...