Critics, including local lawmakers, have raised conflict-of-interest concerns about Optum’s seven-figure contract with the ...

The U.S. Centers for Medicare and Medicaid Services alleges the Indianapolis-based health insurer has failed to properly submit required information to federal regulators since 2018.

Federal regulators are planning to suspend enrollment in Elevance's MA plans at the end of March, in a rare and serious threat to the company’s finances.

The Centers for Medicare and Medicaid Services is freezing enrollment in Elevance Health's Medicare Advantage-Prescription Drug Plans for alleged noncompliance with risk adjustment and data submission ...

A new study published in JAMA found that a new Medicare add-on billing code boosted pay significantly for specialists. The study analyzed Medicare claims data from 2024, the first year that the G22111 ...

The doctors’ association is blowing up the U.S.’ decades-old coding system for recording pregnancy services and starting fresh next year, bowing to calls from OB-GYNs and other maternity specialists.

New resource shows the full impact of the 2026 Physician Fee Schedule changes and how dermatology practices can protect ...

A new JAMA study shows that a new Medicare billing code may have benefited specialists more than the primary care physicians it was designed to help most.

CMS suspend enrollment into Elevance Medicare Advantage plans starting March 31 due to noncompliance with risk adjustment data requirements.

Not long ago, I was sitting across from a nursing home leadership team as they stared at a quality measure report that didn’t make sense to them. “We’re ...

CMS blocks durable medical equipment enrollments nationwide with a six-month moratorium to curb suspected fraudulent billing in Medicare programs.

Having long ago seen the handwriting on the wall for the journalism profession with the debut of GenAI, I decided to just cut to the chase and build my replacement now.