Alexandra Gehrke faces sentencing for a $600 million Medicare healthcare fraud scheme targeting elderly patients, highlighting regulatory and compliance challenges in healthcare billing and Medicare oversight.
The Patients Over Profits Act aims to prohibit ownership of both health plans and providers to curb vertical integration in Medicare-related markets, impacting major payviders like UnitedHealth Group and influencing U.S. healthcare market competition and regulatory enforcement.
Louisiana's Office of Group Benefits is transitioning pharmacy benefit management services from CVS Caremark to Liviniti and SilverScript for 2026 amid legal scrutiny and demand for PBM transparency.
Key Medicare 2025 updates include potential Medigap cost increases and the importance of reviewing the Annual Notice of Change before the December 7 enrollment deadline. Learn about Medicare Advantage plans and state ACA compliance.
Empassion Health study reveals hospice and palliative care reduce healthcare costs by 35% in final year of life while improving care quality for seriously ill patients.
AAASWFL's SHINE Program offers free Medicare counseling for Southwest Florida beneficiaries during the 2025 Open Enrollment Period, facilitating informed insurance decisions and fraud awareness.
CVS Health's Aetna expands nurse-led program to reduce hospital readmissions among Medicare Advantage members, aligning with CMS readmission penalties effective 2027. Program enhances care coordination and post-discharge support in key U.S. hospitals.
Medicare's updated physician fee schedule includes efficiency adjustments and recalculations that will reduce payments for many doctors, impacting physician income and patient access. Workforce shortages and policy adjustments underscore significant challenges in Medicare reimbursement.
Susan McGeehan received the W. Fred Cottrell Alumni Award for leadership in Medicaid managed care, LTSS, and integrated aging services, shaping policy and practice in long-term care.
Medicare to pilot AI-driven preauthorization program in six states as federal budget cuts threaten program funding and patient access.
