Texas Palliative Care Model Cuts Hospitalizations Over 50% Using Data Analytics
Innovative Texas palliative care model leverages data analytics to reduce hospitalizations over 50%, enhancing outcomes and lowering costs for Medicare Advantage plans.
Court Allows Whistleblower FCA Claims Against UnitedHealthcare Over Medicare Part C Billing
Federal court permits whistleblower FCA claims alleging improper Medicare Part C billing by UnitedHealthcare of Georgia, highlighting compliance scrutiny in Medicare Advantage billing.
Peak65 Drives Urgency in Medicare Enrollment Planning for New Retirees
With over 4 million Americans turning 65 in 2024, timely Medicare enrollment during the Initial Enrollment Period is critical to avoid penalties and optimize healthcare coverage. Learn key insights on navigating Medicare plans effectively.
Medicare for All Act Reintroduction Targets Universal Health Coverage Reform
The Medicare for All Act aims to expand Medicare to cover all Americans comprehensively, eliminating premiums and deductibles while addressing health care affordability and systemic inefficiencies.
Medicaid Funding Cuts Loom as House Republicans Aim for $1.5T in Savings
House Republicans target Medicaid cuts and Medicaid expansion funding shifts to meet $1.5 trillion budget reduction goals, risking coverage for millions and stressing providers reliant on Medicaid funding.
Ex-York Pain Management Owner Sentenced for Multi-Million Dollar Medicare Fraud
Rodney L. Yentzer sentenced to 42 months for defrauding Medicare and Medicaid through unnecessary urine drug tests, resulting in multi-million dollar restitution. Case underscores insurance fraud risks in healthcare diagnostic billing.
Infinitus Voice AI Enhances Healthcare Automation for Payers and Providers
Infinitus develops advanced voice AI agents that automate healthcare conversations, improving efficiency and compliance for payers and providers in the U.S. healthcare market.
Federal Medicaid and Medicare Cuts Threaten Rural Hospital Sustainability
Proposed federal cuts to Medicaid and Medicare threaten the financial sustainability of rural hospitals like Monadnock Community Hospital, impacting care delivery and staffing. Explore strategic responses and implications for healthcare reimbursement and compliance.
CMS Proposes FY 2026 Medicare IPPS Rule with Payment and Quality Updates
Explore CMS's FY 2026 proposed Medicare IPPS rule detailing hospital payment increases, uncompensated care funding, quality program updates, and regulatory streamlining affecting hospital reimbursement and compliance for 2025-26.
Medicare Enrollment Rules for Self-Employed with Individual Plans Explained
Understand Medicare enrollment requirements for self-employed individuals with individual health plans to avoid Part B penalties and coverage gaps. Learn key distinctions from group employer plans and enrollment deadlines.