Out-of-network providers charged patients on average 300 percent more than the Medicare rate for certain treatments or procedures, according to the analysis of 2013 and 2014 claims data released Thursday by the America's Health Insurance Plans.
The federal government needs to increase its oversight over private Medicare health plans to make sure seniors have adequate access to doctors and hospitals, according to a report released this week by congressional auditors.
A federal judge has partly sided with providers in ordering the Centers for Medicare & Medicaid to provide further justification for the 0.2 percent payment reduction in provider compensation that will kick in under the two-midnight rule, according to the September 21 ruling in U.S. District Court in Washington D.C.
The health law's upcoming enrollment period may be its toughest yet, with federal officials promising a vigorous outreach campaign to enroll millions of eligible yet hard-to-reach Americans who have yet to sign up for health insurance.
According to new data released by the Centers for Medicare and Medicaid Services on Monday, the U.S. government has paid nearly $2.3 billion through July in incentives to close the coverage gap in 2015.
The National Committee for Quality Assurance recently ranked more than 1,500 health plans by satisfaction and service. The ranking includes private as well as government-sponsored Medicare and Medicaid plans.
Legislators on Thursday were split on the Affordable Care Act's effect on provider and payer competition in the healthcare marketplace in the the first of several hearings to be held by the House Judiciary Subcommittee on Regulatory Reform, Commercial and Antitrust Law.
The Center for Medicare and Medicaid Services has rolled out a new Medicare Advantage Value-Based Insurance Design Model that will be tested in seven states starting in 2017 as a way to trim costs in the treatment of certain chronic conditions.
Amputees against proposed changes to Medicare coverage that would result in less expensive, but inferior, prosthetics being given to patients gathered in Baltimore Wednesday to ask officials to strike down the proposal.
Though critical access hospitals will continue to earn less, Fitch Ratings this week said it does not expect the financial struggles to affect these hospitals' credit ratings due to their near 100 percent reimbursement from Medicare and political support that will stave off any attempt to cut payments.