As reimbursement pressures mount and administrative burdens grow, hospitals and health systems are adopting a firmer stance ...

Medicare Advantage plans are squeezing billions out of the federal government by billing more for patient care, a new study ...

On April 5, the Senate passed an amended fiscal 2025 budget revolution that maintained proposed cuts to Medicaid, including ...

The average Medicare Advantage patient risk score was 1.26, 0.19 higher than the average fee-for-service Medicare risk score, ...

Health insurers in the Medicare Advantage business have a big incentive to diagnose their members with lots of health ...

A Beckley medical clinic and physician agreed to pay more than $150,000 to resolve False Claims Act allegations. According to a press release, on Wednesday, April 2, ...

"Another sentence of probation is not likely to deter this lady from additional fraudulent activity," Judge James L. Graham ...

A Medicaid-funded community service provider allegedly submitted claims to Medicaid for services that were never provided.

Anesthesia billing is complicated and evolving, according to a March 15 blog post from Knack RCM. Here are nine of the ...

Community Options, Inc. and its NY affiliate agreed to a $5 million settlement over Medicaid billing violations.

Five million adults could lose Medicaid coverage next year if Congress enacts work requirements for adults enrolled in Affordable Care Act expansion states, according to the latest analysis from ...