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Providers, health plans and patients alike rarely know how much money any given care will cost each stakeholder, a problem that stifles competition and drives up costs, experts say. The antidote is price transparency, a cause that got a big boost this week when the Healthcare Financial Management Association (HFMA) announced the creation of a task force to improve transparency in healthcare transactions.
 
Less than 0.1% of payments Medicare made in 2011 were for amounts of services that exceeded unpublished CMS limits for “medically unlikely” claims that failed to include reasons to indicate why the services provided were medically necessary, the General Accountability Office (GAO) found.
A Connecticut podiatrist faces a lifetime in prison for billing simple nail care to Medicare as nail avulsions.
A U.S. Supreme Court decision this week that the government can go after drug makers for profit-sharing settlements with generic drug companies may help lower drug costs and increase the number of generics on the market, say some observers.
You probably won’t be shocked to learn that a recent Medical Group Management Association (MGMA) survey shows physician practice ICD-10 readiness is low, as reported by Fierce IT.
Medical malpractice lawyers in New Hampshire are jumping on headlines that for the first time in state history, a jury has ignored a unanimous decision of a medical malpractice panel and awarded $1.5 million to a patient’s family.
Medicare needs to change accountable care organization (ACO) rules set up to prevent ACOs from avoiding the sickest patients to allow the groups to better manage patients with chronic illnesses, says Sen. Ron Wyden, D-Ore.
Physicians looking to benefit financially from participating in an accountable care organization (ACO) may be disheartened by a recent survey from Alpharetta, Ga.-based staffing firm Jackson Healthcare.
Could an insect be contributing to the rise of cardiovascular-related deaths in the U.S.? So says researchers with the U.S. Department of Agriculture Forest Services.
The cost of care for 1 million consumers in a medical home pilot project was lower than projected for 2012, according to results that CareFirst BlueCross BlueShield, which serves the Washington metro area, announced May 6.

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