A new Health Justice Monitor commentary on fraudulent diagnostic upcoding and risk adjustments by Medicare Advantage insurers. Medicare Advantage Costly Diagnostic Upcoding By James G. Kahn, MD/MPH Summary Investigative reporting by Bloomberg highlights the work of whistleblowers and the federal […]
“The exponential growth in these private equity investments in recent years ‘has been associated with a host of trends that are negatively impacting the American people’ — including an increase in nursing home mortality rates….” Private Equity Ownership of […]
Breaking News in Healthcare Reform “While the cap is an important stopgap measure, other reforms to improve the affordability of insulin are urgently needed.” The Winners and Losers of the Proposed Insulin Cost Cap MedPage Today | Kao-Ping Chua, MD, PhD; Rena M. Conti, […]
“…the insurer wanted to ‘suspend growth during this special enrollment season’ and thus would stop paying commissions to brokers who enroll new people in coverage starting April 1. … ‘Why sell something I don’t get paid for?’” ACA Sign-Ups for Low-Income […]
“A few weeks ago, state regulators imposed a record $55 million in fines on L.A. Care, California’s largest Medi-Cal managed-care plan, for failing to ensure adequate care and allowing treatment delays that threatened enrollees’ health. Patient advocates hope the move signals stricter enforcement against other Medi-Cal insurers, […]
Breaking News in Healthcare Reform “CMS has the authority to request a corrective action plan if it finds that a hospital is not compliant….” About 345 Hospitals Have Been Warned About Price Transparency, CMS Says Becker’s Hospital Review | Marissa Plescia | April 4, […]
“Many pharmacists are eager to expand their menu of patient services, but … Pharmacists aren’t generally recognized as service providers under Medicare. … Many private insurers follow Medicare’s lead on payment…For many people, pharmacies are convenient and familiar. More than 90% of people in […]
A new Health Justice Monitor commentary on the intrigues of the medical lobbies. “The pharmaceutical industry needs to come under control of our own public single payer, and the health insurance industry needs to be converted into public stewards serving all of us as […]
