Articles related to Managed Care

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Medicare 14-Day Rule Enforcement Action

[01/29/25]

CMS’s Proposed Rule Clarifies Enrollees’ Medicare Advantage Appeal Rights for Inpatient Admissions and Level of Care Determinations

[01/09/25]

CMS Rule on Agent Broker Compensation Paused by Texas Federal Court

[08/01/24]

CMS Requests Information about Medicare Advantage Data

[03/08/24]

2024 Medicare Physician Fee Schedule Final Rule Makes Changes to Medicare Shared Savings Program

[11/29/23]

FTC Issues Proposed Rule Making Substantial Changes to the Premerger HSR Process

[07/20/23]

CMS Accepting Applications for Participation in Revamped Medicare Shared Savings Program

[05/23/23]

CMS Updates Definition of Marketing for Medicare Advantage and Part D Plans: What Does this Mean for Plans?

[05/16/23]

Scott Strickland Joins Hall Render

[03/20/23]

The End Is Near – Stark Law Blanket Waivers Set to Terminate May 11

[02/20/23]

CMS Publishes RADV Audit Methodology and Intent to Recover Overpayments

[02/14/23]

DOJ Withdraws Decades Old Antitrust Guidance as Scrutiny of Health Care Industry Continues

[02/14/23]

CMS Proposes Major Overhaul to Incorporate Payer Pricing into Medicare Cost Report Data and MS-DRG System

[05/19/20]

The Price May Not Be Right, But It Will Be Public: CMS Finalizes Price Transparency Rule Requiring Hospitals to Publish Payer-Specific Rates

[11/18/19]

Here’s Price Transparency![1]

[09/13/19]

No Surprise Here…the Debate Continues on Surprise Billing

[08/28/19]

Is It Fee-for-Service or Managed Care? CMS Launches Direct Contracting Models

[05/10/19]

CMS Removes Compliance Training Requirements for Downstream Providers Under Medicare Advantage and Part D

[07/05/18]

The Wave of PBM and Insurer Integration Continues as Cigna and Express Scripts Announce a Merger of Their Own

[03/16/18]

Getting Paid for Telehealth Services

[07/11/17]

Non-Network Employer Health Plans – The Struggle Continues

[07/07/17]

U.S. District Court Blocks Second Insurance Mega-Merger; Court Not Impressed with Anthem’s Plan to “Drop the Hammer” on Providers

[03/23/17]

U.S. District Court Blocks $37 Billion Aetna/Humana Merger; Decision Looming in Anthem/Cigna

[01/27/17]

Responding to Non-Network Plans Using Reference-Based Pricing

[09/20/16]