Record-high False Claims Act settlements recovered in first half of 2024
By
Kathleen Steele Gaivin
Jun 21, 2024
After a record-breaking 2023, settlements under the False Claims Act continue along the same trajectory in the first half of 2024, “with notable healthcare fraud settlements under the FCA, AKS [the Anti-Kickback...
Business briefs, June 17
By
Kathleen Steele Gaivin
Jun 17, 2024
Provider groups praise bill streamlining Medicare Advantage prior authorization process … Consumer, industry advocates make recommendations for states to help combat rise in elder real estate fraud,...
2011 to 2020 saw increase in annual prescription meds expenditures
Apr 15, 2024
Metabolic agents were the most costly category; antidiabetic agents were the mostly costly therapeutic area.
Congress advisers back permanent telehealth expansions, look to nix in-person rule for behavioral telehealth...
By
Kimberly Marselas
Apr 12, 2024
Maintaining Medicare access to telehealth services must remain a priority, members of a congressional advisory panel said Thursday.
Ongoing lawsuits indicate there’s little advantage to seniors for letting AI determine their MA coverage
By
Aaron Dorman
Apr 04, 2024
A new report calls out the role of AI in validating cost-cutting measures that leave seniors in need without coverage.
CMS readies providers for Interoperability and Prior Authorization rule
By
Adam Healy
Apr 03, 2024
CMS offered providers resources to help prepare for the newly finalized Interoperability and Prior Authorization final rule.
Business briefs, April 2
By
Kathleen Steele Gaivin
Apr 02, 2024
CMS finalizes 3.7% adjustment in MA rates for 2025 … Experts fear ‘bigger, stronger stick’ in new Medicare pay rule … White House designates April as Case Workers Recognition Month … National...
Business briefs, April 1
By
Kathleen Steele Gaivin
Apr 01, 2024
Higher interest rates mean less access to capital for senior living: NIC … CMS proposes 4.1% nursing homes pay boost … Assisted living rates up 0.6 to 3.8% … American Society on Aging, Next50 launch...
Medicare to cover Wegovy when patients also have heart disease
Mar 22, 2024
Medicare will now cover the popular weight-loss drug Wegovy if patients using it also have heart disease, US officials announced Thursday.
‘Landmark legislation’ aims to streamline, coordinate care for 12 million dually eligible individuals
By
Kimberly Bonvissuto
Mar 21, 2024
A bipartisan bill aiming to streamline and coordinate care for the nation’s more than 12 million dually eligible individuals — people who are enrolled in both Medicare and Medicaid — is being called...